摘要目的 运用抗体CD123观察浆细胞样树突状细胞在组织细胞坏死性淋巴结炎(又称Kikuchi病)中表达的数量及分布模式,探讨将CD123作为Kikuchi病辅助诊断依据的重要性及意义.方法 收集诊断明确的30例Kikuchi病;5例间变性大T细胞淋巴瘤、10例淋巴组织反应性增生病例和10例慢性扁桃体炎作为对照病例,通过复习HE切片并应用免疫组织化学EliVision法检测这几种病变中CD123的表达情况.结果 在30例Kikuchi病中有28例(93.3％)均可见CD123呈中等或强阳性的成簇浆细胞样树突状细胞出现,且多分布于病灶周围与T细胞毗邻处及血管周.CD123呈现三种阳性部位:表现细胞膜阳性10例;细胞质阳性10例;细胞膜和细胞质同时阳性8例.在对照组,反应性增生及慢性扁桃体炎病例中CD123均为细胞质阳性.对于成簇浆细胞样树突状细胞的密集度及CD123的阳性程度,病例组中42.9％(12/28)为3+;28.6％(8/28)为2+;28.6％(8/28)为+.在对照组,反应性增生(1/10)、慢性扁桃体炎(2/10)病例中散在表达(+),仅部分区域呈小簇存在,阳性细胞总体数量不高.而在5例间变性大T细胞淋巴瘤中未见明确CD123的成簇表达.病理分期中CD123阳性表达多见于增生型(43.3％,13/30)及坏死型(50.0％,15/30).结论 大量成簇浆细胞样树突状细胞之CD123的普遍中度至强度表达可以作为Kikuchi病的一个重要辅助诊断标记.同时,CD123表达多集中于Kikuchi病的增生型及坏死型.

abstractsObjective To investigate the mode of presentation,cytologic features of the plasmacytoid dendritic cells (pDC),and the expression of CD123 and its significance in Kikuchi's disease.Methods CD123 expression was evaluated by EliVision immunohistochemical staining in formalin-fixed and paraffin-embedded tissues from 30 cases of Kikuchi's disease,5 cases of T cell lymphoma,10 cases of reactive lymphoid hyperplasia and 10 cases of chronic tonsillitis.Results Clusters of CD123 positive PDC were observed in Kikuchi's disease (28 of 30 cases,93.3％) and the staining intensity was more prominent in the PDC at the periphery of the lesion and around the high endothelial venule-like vessels.CD123 showed three staining patterns:membranous (10 cases,33.3％),cytoplasmic (10 cases,33.3％),and membranous and cytoplasmic (8 cases,26.7％).In the control group,CD123 showed cytoplasmic staining in reactive hyperplasia and chronic tonsillitis.Regarding the staining intensity,12 of 28 cases (42.9％)were3+ for CD123,8 of 28 cases (28.6％) were 2 +,and 8 of 28 cases (28.6％) were 1 +.In contrast,PDC clusters with 1 + staining intensity were observed in 1 of 10 cases of reactive lymphoid hyperplasia; 2 of 10 chronic tonsillitis diseases; and much less in T cell lymphoma.Conclusions Large cluster of PDC is detected in both proliferative and necrotizing types of Kikuchi's disease,making this a useful adjunctive diagnostic marker.