背景:研究表明透明血管型Castleman病(HVCD)的免疫表型缺乏特征,这很容易与其他疾病混淆。
方法:选取2010年1月至2022年6月陕西省人民医院病理科和陕西省肿瘤医院病理科17例HVCD患者。选择13例反应性增生性淋巴结(RHL)和11例滤泡性淋巴瘤(FL)作为对照组。所有病例均行CD3、CD20、CD21和BCL2免疫组化染色。
结果:(i)在17例HVCD中,生发中心BCL2的阴性面积明显小于生发中心CD3的阴性面积。然而,在13例RHL中,生发中心CD3阴性区与生发中心BCL2阴性区基本一致。在11例FL中,在肿瘤卵泡中,CD3阴性区与BCL2阳性区基本一致。HVCD组与其他两组疾病比较差异有统计学意义(P<0.05)。(ii)在17例HVCD中,生发中心BCL2的阴性面积明显小于CD21表达的滤泡树突状细胞(FDC)网。然而,在13例RHL中,CD21表达的FDC网状物与生发中心BCL2的阴性区域基本一致。在11例FL中,在肿瘤卵泡中,CD21表达的FDC网状物与BCL2阳性区域基本一致。HVCD组与其他两组疾病比拟差别有统计学意义(P<0.05)。
结论:HVCD具有独特的免疫表型特征。生发中心BCL2的阴性区域明显小于CD3的阴性区域。生发中心BCL2的阴性面积明显小于CD21表达的FDC网状物。HVCD的这两种免疫表型特征在诊断和鉴别诊断中非常重要。
BACKGROUND: Studies suggested that the immunophenotype of hyaline vascular type Castleman disease (HVCD) lacked characteristics, which was easy to be confused with other diseases.
METHODS: From January 2010 to June 2022, 17 cases of HVCD were selected from the Department of Pathology of Shaanxi Provincial People\'s Hospital and the Department of Pathology of Shaanxi Provincial Cancer Hospital. 13 cases of reactive hyperplastic lymph nodes (RHL) and 11 cases of follicular lymphoma (FL) were selected as the control group. All cases were performed CD3, CD20,
CD21 and BCL2 immunohistochemical staining.
RESULTS: (i) In 17 cases of HVCD, the negative area of BCL2 of germinal center was significantly smaller than the negative area of CD3 of germinal center. However, in 13 cases of RHL, the negative area of CD3 of germinal center was basically consistent with the negative area of germinal center of BCL2 of germinal center. In 11 cases of FL, in neoplastic follicles, the negative area of CD3 was basically consistent with the positive area of BCL2. The difference between HVCD group and other two groups of diseases was statistically significant (P < 0.05). (ii) In 17 cases of HVCD, the negative area of BCL2 of germinal center was significantly smaller than the follicular dendritic cell (FDC) meshworks expressed by
CD21. However, in 13 cases of RHL, the FDC meshworks expressed by
CD21 were basically consistent with the negative area of BCL2 of germinal center. In 11 cases of FL, in neoplastic follicles, the FDC meshworks expressed by
CD21 was basically consistent with the positive area of BCL2. The difference between HVCD group and other two groups of disease was statistically significant (P < 0.05).
CONCLUSIONS: HVCD has unique immunophenotypic characteristics. The negative area of BCL2 of germinal center is significantly smaller than the negative area of CD3. The negative area of the BCL2 of germinal center is significantly smaller than the FDC meshworks expressed by
CD21. These two immunophenotypic features in HVCD are very important in diagnosis and differential diagnosis.