CD10阴性对滤泡性淋巴瘤病理诊断的价值  

Value of loss of CD10 expression in pathologic diagnosis of follicular lymphoma

作　　者：谢建兰[1] 周小鸽[1] 金妍[1] 朱红[1] 郑媛媛[1] 张淑红[1] 张彦宁[1] 张晓敬[1] 郑晓丹[1] 

机构地区：[1]首都医科大学附属北京友谊医院病理科,100050

出　　处：《中华病理学杂志》2009年第11期754-758,共5页Chinese Journal of Pathology

基　　金：基金项目：国家自然科学基金（30670892）

摘　　要：目的探讨CD10阴性在滤泡性淋巴瘤（FL）中的诊断和鉴别诊断价值。方法对126例FL进行常规形态学观察和免疫组织化学EliVision二步法染色，并以31例淋巴结反应性滤泡增生（RFH）作为对照。结果37例（29．4％）FL出现CD10阴性。表现为所有滤泡CD10阴性（33／37，89％）、大部分滤泡CD10阴性（3／37，8％）和少数滤泡CD10阴性（1／37，3％）三种情况。并且CD10阴性病例主要为高级别FL。组织形态上，这些CD10阴性病例标本均存在滤泡样结构，高级别FL的滤泡大小不等，边缘不规则；低级别FL的滤泡大小比较均一，边缘圆整。大多数病例的滤泡内可见胞质空亮细胞，类似单核样B细胞。在31例RFH病变中，除个别滤泡或散在少数萎缩退化的滤泡外，均未见滤泡CD10阴性。结论FL和RFH具有不同的CD10表达特点，据此可将CD10阴性作为鉴别两者的一项参考指标。Objective To study the value of loss of CDIO expression in the diagnosis and differential diagnosis of follicular lymphoma （FL）. Methods One hundred and twenty-six cases of FL and 31 cases of reactive follicular hyperplasia （RFH） were studied with routine microscopy and immunohistochemistry. Results Loss of CDIO expression was observed in 37 cases （29.4%） of FL. Three patterns of CD10 loss were demonstrated, as follows： diffuse CD10 loss in all of the neoplastic follicles （33/37, 89% ）, CD10 loss in most follicles （3/37, 8% ） and CDIO loss in only a few follicles （1/37, 3% ）. In general, loss of CD10 was frequently seen in higher-grade FL. Morphologically, the cases with CD10 loss showed follicular architecture. The neoplastic follicles in high-grade FL were of various sizes and showed irregular margins, while those in low-grade FL were relatively uniform in size with regular margin. Sometimes, the CD10-negative FL cells contained a clear cytoplasm, mimicking monoeytoid B cells. On the other hand, CD10 expression was found in all of the 31 cases of RFH studied, with the exception of occasional individual or regressed follicles. Conclusions The expression of CD10 differs in FL and RFH. Loss of CD10 expression is seen mainly in FL. It is thus considered as a valuable parameter in differentiating between FL and RFH.

关 键 词：淋巴瘤 滤泡型 增生 胞啡肽酶 诊断 鉴别 

分 类 号：R686[医药卫生—骨科学]