摘要目的 研究血管免疫母细胞性T细胞淋巴瘤(AITL)形态学特点、特异性标志物,并探讨AITL中滤泡树突状细胞网的增生状况及其起源.方法 对29例AITL行bcl-6、CD10、CXCL13、CD21染色(EliVision法)及bcl-6/CD3、CD10/CD21及CD10/CD20双重染色,并选取外周T细胞淋巴瘤,非特殊类型(PTL-U);结外NK/T细胞淋巴瘤,鼻型;间变性大细胞淋巴瘤(ALCL);肠病性T细胞淋巴瘤(ETTL);皮下脂膜炎性T细胞淋巴瘤及淋巴结反应性增生作为对照.结果 (1)22例(75.9%)AITL表达CD10,对照组除1例PTL-U外均阴性;24例(82.8%)AITL表达CXCL13,所有PTL-u均阴性;而AITL中bcl-6的表达情况和PTL-u及反应性增生病例有一定程度的交叉.(2)29例AITL显示特征性的CD21阳性滤泡树突状细胞网增生,4例具有明显生发中心的病例,2例显示增生的滤泡树突状细胞网覆盖并超过生发中心.结论 AITL具有典型的形态学变化,CD10和CXCL13是AITL特异性标志物,而bcl-6不具有特异性;AITL中增生的滤泡树突状细胞网可能部分起源于生发中心.

abstractsObjective To study the morphologie and immunophenotypic features of angioimmunoblastic T-cell lymphoma (AITL) , as well as the origin of the proliferative follicular dendritic cells(FDCs) in AITL Methods lmmunohistochemical study for CD10, CXCL13, bcl-6 and CD21 was performed on 29 cases of AITL. Double immunostaining for bcl-6/CD3, CD10/CD21 and CD10/CD20 were also carried out. Cases of peripheral T-cell lymphoma, unspecified, extranodal NK/T-cell lymphoma, nasal-type, enteropathy-type T-cell lymphoma, anaplastic large cell lymphoma, subcutaneous panniculitis-like T-cell lymphoma and reactive lymphoid proliferation were selected as controls. Results Amongst the 29 cases of AITL studied, 75.9% (22/29) showed aberrant expression of CD10, while all except one of the controlled eases were negative, 82.8% (24/29) of the AITL cases expressed CXCL13, while all cases of peripheral T-cell lymphoma, unspecified were negative. As for bcl-6 staining, although the highest percentage of bcl-6-positive cells was observed in AITL, the expression pattern was not useful in differentiating AITL from peripheral T-cell lymphoma, unspecified and lymphoid reaction. Besides, all cases of AITL demonstrated the characteristic proliferation of follicular dendritic cells. Two of the cases, which contained obvious germinal centers, had the follicular dendritic cell meshwork extending beyond the lymphoid follicles. Conclusions As compared with bcl-6, CD10 and CXCL13 are specific and sensitive markers in diagnosing AITL. Part of the proliferative FDCs in AITL may originate from the germinal centers.