摘要
目的探讨IgG4相关性疾病(IgG4-related disease,IgG4-RD)的临床病理学特征、诊断及鉴别诊断。方法回顾性分析10例IgG4-RD患者的临床病理资料,采用免疫组化EnVision两步法检测IgG、IgG4、CD138、Κappa轻链、Lamda轻链抗体在IgG4-RD中的表达。结果10例IgG4-RD患者中90%为老年男性,主要的组织病理学特征为席纹状纤维化伴致密淋巴浆细胞浸润,少数病例伴闭塞性静脉炎。免疫表型:IgG4+浆细胞数及IgG4+/IgG+浆细胞比率均升高(IgG4+浆细胞数>50个/HPF,IgG4+/IgG+浆细胞比率>40%)。结论IgG4-RD的临床病理学特征以纤维炎症性改变为主,免疫组化检查发现IgG4+浆细胞数绝对值和相对值升高具有重要的诊断价值。
Purpose To investigate the clinicopathologic features,diagnosis and differential diagnosis of IgG4-related disease.Methods Retrospective analysis of clinical pathological data of 10 cases with IgG4-RD,using immunohistochemical technique to detect the expression of IgG4,IgG,CD138,Κappa light chain and Lamda light chain antibody in IgG4-RD.Results Among the 10 cases of IgG4-RD,90%were elderly males.The critical histopathological features were storiform pattern of fibrosis,with dense lymphoplasmacytic infiltration,and obliterative phlebitis was also observed in a few cases.Immunohistochemical results showed an increase in IgG4+plasma cell count and IgG4+/IgG+plasma cell ratio in all cases(IgG4+plasma cell count>50/HPF,IgG4+/IgG+plasma cell ratio>40%).Conclusion The clinicopathological features of IgG4-RD were mainly fibrous inflammatory changes.The increase of absolute and relative IgG4+plasma cell number by pathological examination has important diagnostic value.
作者
马少飞
林军
臧丽娟
赵凌舟
欧学平
MA Shao-fei;LIN Jun;ZANG Li-juan;ZHAO Ling-zhou;OU Xue-ping(Department of Pathology,,Shanghai Jiaotong University School of Medicine,Shanghai 200080,China;Department of Nuclear Medicine,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200080,China;Department of Stomatology,Minhang Hospital,Fudan University,Shanghai 201100,China)
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2021年第4期415-419,共5页
Chinese Journal of Clinical and Experimental Pathology
基金
国家自然科学基金青年基金(81801727)。
