血管免疫母细胞性T细胞淋巴瘤皮肤病变中TFH标记物的表达和RHOA p.G17V及IDH2 p.R172K/S突变的检测
  ——本文经《美国外科病理学杂志》授权发布,其他媒体转载或引用须经《美国外科病理学杂志》同意,否则追究法律责任。
  
  对41例血管免疫母细胞性T细胞淋巴瘤患者的皮肤活检结果进行回顾性分析,检测其滤泡辅助性T细胞(follicular helper T-cell,TFH)标记物及EB病毒(Epstein-Barr virus,EBV)的表达情况,并采用等位基因特异性聚合酶链反应的方法分析其RHOA(p.G17v)及IDH2(p.R172K/S)的突变情况。我们把所有病例分成4种形态学模式:(1)血管周围淋巴细胞低密度浸润(n=11), (2)血管周围异型淋巴组胞密集浸润,偶见炎细胞(n=13), (3)血管免疫母细胞性T细胞淋巴瘤样肿瘤细胞弥漫浸润(n=4), (4)其他模式(n=13)。观察到2例EBV+和2例浆细胞样淋巴组织增生性疾病。我们观察到TFH标记物在这些病例中的表达不同[CD10(50%)、BCLB6 (84%)、PD1(94%)、CXCL13(84%)和ICOS (97. 5%)],并观察到EBV+的B免疫母细胞(26%)。TFH表型在最具诊断挑战性的模式1和2中检出率分别为82%和73%。TFH标记物和EBV检测有助于诊断这些细胞低密度浸润病例。我们发现RHOA G17V和IDH2 R172K/S突变在皮肤病变中的检出率分别为14/18(78%)和3/16(19%)。在一部分具有诊断挑战性模式1和2的活检病例中可以检测到RHOA G17V突变。皮肤活检和淋巴结(lymph node, LN)活检均发现RHOA G17V突变的检出率为7/9(64%),只在皮肤或LN病变中发现RHOA G17V突变的各有1例。RHOA G17V突变在皮肤病变中的检出率与既往报到在LN病变中的检出率相似。RHOA G17V突变可能是血管免疫母细胞性T细胞淋巴瘤皮肤病变诊断的一个敏感标记物,尤其对诊断肿瘤细胞低密度浸润的病例有帮助。
Am J surg Pathol 2017;41;1581-1592
美国外科病理学杂志中文版2018年第二期摘要No.2
(王冠男 翻译 石怀银 审校)
  The American Journal of Surgical Pathology中文版声明:
  ©2018 Wolters Kluwer Health
  The material is published by Wolters Kluwer Health with the permission of American Journal of Surgical Pathology.No part of this publication may be reproduced in any form,stored in a retrieval system or transmitted in any form,by any means,without prior written permission from Wolters Kluwer Health.Opinions expressed by the authors and advertisers are not necessarily those of the American Journal of Surgical Pathology, its affiliates,or of the Publisher.The American Journal of Surgical Pathology,its affiliates,and the Publisher disclaim any liability to any party for the accuracy,completeness,efficacy,or availability of the material contained in this publication (including drug dosages) or for any damages arising out of the use or non-use of any of the material contained in this publication.
  Although advertising material is expected to conform to ethical (medical) standards,inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer.

  【本文经《美国外科病理学杂志》授权发布,其他媒体转载或引用须经《美国外科病理学杂志》同意 ,否则追究法律责任;所有文章仅供公益交流,不代表本站立场。欢迎提供素材、资料等,投稿邮箱: tougao@91360.com,一经采纳将给予稿费】