霍奇金淋巴瘤的免疫表型与鉴别诊断

Immunophenotype and differential diagnosis of Hodgkin's lymphoma

目的 研究霍奇金淋巴瘤 (HL)的免疫表型和鉴别诊断。方法 采用SP免疫组化法检测 5 6例HL患者瘤细胞及背景细胞的免疫表型 ,根据WHO 2 0 0 0淋巴瘤新分类重新评价。结果 HL患者 47例 ,其中结节性淋巴细胞为主型HL(NLPHL) 2例 ,经典型HL(CHL) 4 3例 ,未分类 2例 ;富于T细胞的B细胞淋巴瘤 (TCRBCL) 6例 ,间变性大细胞淋巴瘤 (ALCL) 2例以及转移性肿瘤 1例。NLPHL中L&H细胞呈CD2 0 (+) ,CD1 5(- ) ,CD3 0 (- ) ;背景细胞中TIA 1阳性细胞稀少 ,CD57阳性细胞多见。CHL中诊断性R S细胞及变异型R S细胞呈CD1 5(+) (81% ) ,CD3 0 (+) (10 0 % ) ,其中 3例共同表达CD2 0 呈弱阳性 ;背景细胞中TIA 1阳性细胞多见 ,而CD57阳性细胞稀少。TCRBCL中瘤细胞呈CD2 0(+) ,CD1 5(- ) ,CD3 0 (- ) ;背景细胞中TIA 1阳性细胞增多 ,CD57阳性细胞少见。ALCL中瘤细胞呈CD3(+) ,CD3 0 (+) ,ALK 1(+) ,CD1 5(- ) ,CD2 0 (- ) ,背景细胞中TIA 1阳性细胞多见 ,CD57阳性细胞少见。结论 石蜡免疫组化检测瘤细胞CD2 0 、CD3 、CD1 5、CD3 0 以及背景细胞TIA 1、CD57、CD2 0 和CD45RO 的表达 。

Objective To study the immunophenotype and differential diagnosis of Hodgkin's lymphoma (HL).Method Fifty six cases originally diagnosed as HL were re-evaluated according to lymphoma classification of WHO 2000 on paraffin sections using SP immunohistochemistry.Results Among the 56 cases, 47 met the WHO creteria for HL, 8 were NHL and 1 metastatic tumor. Of the 47 HL cases, 2 were nodular lymphocyte predominant HL(NLPHL), 43 classical Hodgkin's lymphoma(CHL) and 2 unclassified HL, and of the 8 cases reclassified as NHL, 6 were T-cell rich B-cell lymphoma(TCRBCL) and 2 anaplastic large cell lymphoma(ALCL). In NLPHL cases, L&H cells were CD 20 +, CD 15 - and CD 30 -; CD 57 + cells and small B-lymphocytes predominated the background infiltration. Diagnostic R-S cells and other tumor cells in 43 cases of CHL were positive for CD 30(100%), CD 15(81%) and CD 20(7%). Six cases of TCRBCL were negative for CD 15 and CD 30. Two cases of ALCL were positive for CD 30, ALK-1 and CD 3, and negative for CD 15 and CD 20. The reactive inflammatory infiltration in CHL and TCRBCL was rich in TIA-1 positive cytotoxic lymphocytes, and CD 57 + cells were rarely encountered. Conclusion Combining the immunophenotype of tumor cells and background cells with morphologic criteria are more helpful for classification of HL, and discrimination between NLPHL,CHL and TCRBCL.