CD38在滤泡性淋巴瘤和淋巴滤泡反应性增生中的鉴别诊断价值研究

摘要

Objective To explore the significance of expression of CD38 in differential diagnosis of follicular lymphoma(FL)from reac-tive follicular hyperplasia(RFH)in immunodetection of paraffin - embedded tissue sections. Methods Twenty - five specimens of RFH and forty- two specimens of FL were examined by light microscopy and immunohistochemical staining. Results In RFH cases,the immunoreactivity of CD38 was observed in centrocytes and centroblasts throughout the germinal center(GC)with weak to moderate uniform staining intensity,and a subset of strongly positive cells predominantly located in the light zone,indicating a typical dual expression pattern. CD38 staining revealed three patterns in FL. In pattern I(32 cases),tumor cells maintained CD38 expression within the neoplastic follicles,which exhibited weak to moderate uniform staining intensity. In 30 of these cases,the neoplastic follicles were entirely devoid of CD38 strongly positive cells,whereas only rare, scattered strongly positive cells were observed in a minority of neoplastic follicles in the remaining two cases. In pattern II(10 cases),tumor cells in neoplastic follicles exhibited loss of CD38 expression accompanied with the disappearance of strongly positive plasma cell precursors. Conclu-sion In comparison with the reactive GCs,the almost entire lack of cells with strong expression of CD38 in follicular structures was the most strik-ing alteration. The results presented here demonstrate that immunohistochemical staining for CD38 in paraffin - embedded sections is a simple and easy method for differentiating FL from RFH.%目的：探讨 CD38对滤泡性淋巴瘤（FL）和反应性滤泡增生（RFH）的鉴别诊断价值。方法对25例 RFH和42例 FL 病例进行形态学及免疫组化对照分析。结果25例 RFH 病例均显示 CD38在反应性生发中心呈典型双相表达模式：生发中心弥漫弱表达 CD38，此外还有少量 CD38强阳性细胞，后者主要位于明暗区交界处与明区。CD38在FL 中有2种表达模式：模式1（32例）显示肿瘤性滤泡中的瘤细胞弥漫一致的弱-中等阳性，其中30例完全没有强阳性细胞，2例仅在个别滤泡有很少强阳性细胞；模式2（10例）显示肿瘤性滤泡 CD38完全阴性。共同特点是无论瘤细胞是否表达 CD38，肿瘤性滤泡中缺乏强阳性细胞，或仅在个别滤泡见到很少强阳性细胞。结论 CD38在 FL 和 RFH 中有截然不同的表达模式，可为二者的鉴别提供新的依据。