摘要：最近我们偶然遇到1例原发性肺血管瘤样纤维组织细胞瘤（angiomatoid fibrous histiocytoma，AFH），因免疫组织化学（immunohistochemistry，IHC）显示间变性淋巴瘤激酶（anaplastic lymphoma kinase，ALK）阳性，之前被误诊为炎性肌纤维母细胞瘤（inflammatory myofibroblastic tumor，IMT）。为此，我们采用3种不同克隆号（D5F3、5A4、ALK1）的抗体对11例AFH、15例IMT和11例滤泡树突细胞（follicular dendritic cell，FDC）肉瘤的ALK表达进行检测。使用ALK断裂双色荧光探针进行荧光原位杂交（fluorescence insitu hybridization，FISH）对ALKIHC阳性病例进行分析。结果显示，大多数AFH病例至少表现一种克隆号（9/11的D5F3阳性，6/9的5A4阳性，1/9的ALK1阳性）的ALKIHC阳性，呈胞浆中等至强阳性染色。通过使用ALK基因拷贝数在1.6~2.1间的FISH检测发现，ALKIHC阳性的AFH病例均无ALK基因重排（0/8）。IMT中67%的病例ALKIHC阳性（10/15的D5F3阳性，8/15的5A4阳性，7/15的ALK1阳性），FISH显示，10例病例中有9例的ALK基因重排阳性。所有FDC肉瘤的ALKIHC（D5F3和5A4）均为阴性。我们的结果显示，AFH中常见ALK的表达，特别在使用D5F3和5A4高敏性抗体和增敏检测系统，也可能是导致AFH与IMT诊断混淆的潜在原因。AFH中ALK表达的具体分子机制尚不清楚，并非为ALK基因重排或基因扩增所致。
关键词：间变性淋巴瘤激酶（ALK），血管瘤样纤维组织细胞瘤（AFH），炎性肌纤维母细胞瘤（IMT），上皮样纤维组织细胞瘤（EFH），原发性肺黏液样肉瘤（PPMS）
（Am J Surg Pathol 2019；43：93-101）
美国外科病理学杂志中文版2019年第三期摘要NO.10
( 时雨 张华蓉 翻译 阎晓初 审校 )
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©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.
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【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】
©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】
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