鼻咽部恶性淋巴瘤的诊断与免疫组化

应用免疫组化方法对１１例鼻咽部恶性淋巴瘤、１０例鼻咽部低分化癌、８例鼻咽部反应性淋巴组织增生进行了上皮性标记（Ｋｅｒａｔｉｎ、、ＥＭＡ）、淋巴组织标记（ＬＣＡ、Ｌ２６、ＤＣＨＬ１）及免疫球蛋白（Ｋ轻链、λ轻链）标记。结果发现：①恶性淋巴瘤ＬＯＡ９１％阳性，Ｋｅｒａｔｉｎ、ＥＭＡ阴性；低分化癌ＬＣＡ阴性，Ｋｅｒａｔｉｎ、ＢＭＡ阳性；②Ｂ细胞性淋巴瘤，Ｋ轻链阳性或λ轻链阳性占８２％，呈单克隆表型；而反应性增生，Ｋ轻链λ轻链均阳性，呈多克隆表型；③淋巴瘤的分型：Ｌ２６阳性６例，提示Ｂ细胞性淋巴瘤；ＵＣＨＬ１阳性４例，提示为Ｔ细胞性淋巴瘤，Ｔ：Ｂ为１：１．５。初步认为免疫组化有助于鼻咽部恶性淋巴瘤的诊断及鉴别诊断，并探讨其组织来源以指导临床制定合理的治疗方案及判断预后。     

应用PCR检测石蜡包埋骨髓活检标本B淋巴细胞克隆性增生

应用聚合酶链反应（ＰＣＲ）检测慢性Ｂ细胞性白血病、多发性骨髓瘤及Ｂ细胞恶性淋巴瘤骨髓浸润的石蜡包埋骨髓活检标本克隆性免疫球蛋白重链（ＩｇＨ）基因重排共１９例，其中１６例检测出ｌｇ基因单克隆性重排，总阳性率为８４％。非肿瘤大致正常骨髓标本和急性粒细胞白血病骨髓标本则出现多克隆性弥漫带或无扩增产物。以上结果表明：石蜡包埋骨髓活检标本来源的ＤＮＡ可用于ＰＣＲ检测单克隆性ＩｇＨ基因重排。     

眼附属器淋巴组织增生性病变基因重排分析

目的探讨眼附属器淋巴组织增生性病变的免疫球蛋白重链(IgH)基因重排特点及应用价值。方法收集22例眼附属器淋巴组织增生性病变,其中淋巴瘤8例,非典型淋巴组织增生病变6例,反应性增生的淋巴组织8例。运用标准试剂盒提取DNA,采用半巢氏PCR技术、2对引物进行IgH基因重排检测,同时运用免疫组化2步法标记抗体(LCA,CD3 CD20,CD79a,CD45RA,CD45RO,Bcl-2等)。结果 6例非典型淋巴组织增生性病变中IgH基因单克隆重排4例阳性(67%),8例淋巴瘤中IgH基因单克隆重排8例阳性(100%),反应性增生的淋巴组织基因重排阴性。所有12例病例均经免疫组织化学染色,全部为非霍奇金B细胞淋巴瘤,其中黏膜相关淋巴组织结外边缘区淋巴瘤(MALT)B细胞淋巴瘤8例,弥漫大B细胞淋巴瘤(DLBCL)2例,滤泡性淋巴瘤(FL)1例,淋巴浆细胞淋巴瘤(LPL)1例。结论基因重排检测是眼附属器疑难淋巴组织增生性病变和淋巴瘤鉴别诊断的有效方法,可以有效地提高诊断的准确率。     

成人淋巴母细胞性淋巴瘤临床病理分析

目的：探讨成人淋巴母细胞性淋巴瘤的临床病理特征及鉴别诊断要点。方法：对8例成人淋巴母细胞性淋巴瘤进行病理组织学和免疫组化标记观察，并复习其临床资料及相关文献。结果：本组8例患者的年龄30-56岁，其中7例为发生于淋巴结和纵隔的成人T淋巴母细胞性淋巴瘤；1例为发生于皮肤的成人B淋巴母细胞性淋巴瘤。组织学瘤细胞中等大小，呈弥漫分布，细胞界限不清，染色质细颗粒样或粉尘状，核分裂相多见，可见“星空现象”。免疫组化显示瘤细胞表达TdT和CD99。结论：成人淋巴母细胞性淋巴瘤是一种少见的高度恶性淋巴造血系统肿瘤，组织学和免疫组化有一定特征，诊断时应注意与其他肿瘤鉴别。     

Analysis of ocular adnexal hyperplastic lesions lymphatic organization gene rearrangement

目的 探讨眼附属器淋巴组织增生性病变的免疫球蛋白重链(IgH)基因重排特点及应用价值.方法 收集22例眼附属器淋巴组织增生性病变,其中淋巴瘤8例,非典型淋巴组织增生病变6例,反应性增生的淋巴组织8例.运用标准试剂盒提取DNA,采用半巢氏PCR技术、2对引物进行IgH基因重排检测,同时运用免疫组化2步法标记抗体(LCA,CD3 CD20,CD79a,CD45RA,CD45RO,Bcl-2等).结果 6例非典型淋巴组织增生性病变中IgH基因单克隆重排4例阳性(67%),8例淋巴瘤中IgH基因单克隆重排8例阳性(100%),反应性增生的淋巴组织基因重排阴性.所有12例病例均经免疫组织化学染色,全部为非霍奇金B细胞淋巴瘤,其中黏膜相关淋巴组织结外边缘区淋巴瘤(MALT)B细胞淋巴瘤8例,弥漫大B细胞淋巴瘤(DLBCL)2例,滤泡性淋巴瘤(FL)1例,淋巴浆细胞淋巴瘤(LPL)1例.结论 基因重排检测是眼附属器疑难淋巴组织增生性病变和淋巴瘤鉴别诊断的有效方法,可以有效地提高诊断的准确率.     

鼻咽部恶性淋巴瘤的诊断与免疫组化

应用免疫组化方法对１１例鼻咽部恶性淋巴瘤，１０例鼻咽部低分化癌、８例鼻咽部反应性淋巴组织增生进行了上皮性标记（Ｉｅｒａｔｉｎ．ＥＭＡ）、淋巴组织标记（ＬＣＡ、Ｌ２６、ＵＣＨＬ１）及免疫球蛋白（）Ｋ轻链、λ轻链）标记。结果发现：（１）恶性淋巴瘤ＬＣＡ９１％阳性，Ｋｅｒａｔｉｎ，ＥＭＡ阴性；低分化癌ＬＣＡ阴性，Ｋｅｒａｔｉｎ，ＥＭＡ阳性；（２）Ｂ细胞性淋巴瘤Ｋ轻链阳性或λ轻链均阳性，呈多克隆表型；（３     

眼附属器淋巴组织增生性病变基因重排分析

目的 探讨眼附属器淋巴组织增生性病变的免疫球蛋白重链（IgH）基因重排特点及应用价值。方法 收集 22 例眼附属器淋巴组织增生性病变,其中淋巴瘤 8 例,非典型淋巴组织增生病变 6 例,反应性增生的淋巴组织 8 例。运用标准试剂盒提取 DNA,采用半巢氏 PCR 技术,采用 2 对引物进行 IgH 基因重排检测。同时运用免疫组化二步法标记（LCA,CD3,CD20,D79a,CD45RA,CD45RA,Bcl-2 等）抗体。结果 6 例非典型淋巴组织增生性病变中 IgH 基因单克隆重排 4 例阳性（67%）。8 例淋巴瘤中 IgH 基因单克隆重排 8 例阳性（100%）。反应性增生的淋巴组织基因重排阴性。所有 12 例病例均经免疫组织化学染色,全部为非霍奇金 B 细胞淋巴瘤,其中粘膜相关淋巴组织结外边缘区淋巴瘤(MALT)B 细胞淋巴瘤 8 例,弥漫大 B 细胞淋巴瘤(DLBCL)2 例,滤泡性淋巴瘤(FL)1 例,淋巴浆细胞淋巴瘤（LPL）1 例。结论 基因重排检测是眼附属器疑难淋巴组织增生性病变和淋巴瘤鉴别诊断的有效方法,可以有效地提高诊断的准确率。     

原发性肾脏恶性淋巴瘤临床与病理分析

报道5例罕见的原发性肾脏恶性淋巴瘤的临床病理及免疫组织化学特点，结果显示：5例均为B细胞标记阳性，表明：本瘤是一种低度恶性肿瘸属粘膜相关淋巴瘤(B细胞性淋巴瘸)，手术切除后加用放疗或化疗，预后较好，本结合献复习对该瘤的临床病理与鉴别诊断进行了讨论。     

非何杰金氏淋巴瘤的酶组织化学

对30例非何杰金氏淋巴瘤进行酶组织化学研究。结果显示19例B淋巴瘤中有16例为ATPase阳性,6例T淋巴瘤中各有3例分别为AcP和ANAE点状阳性。ATPase可以作为B淋巴瘤的标记之一,其活性可能与B细胞的分化有关。AcP可以作为T细胞性的曲核淋巴母细胞淋巴瘤的标记。     

胃粘膜相关淋巴组织结外边缘区B细胞淋巴瘤9例临床病理分析

目的 研究胃发生粘膜相关淋巴组织结外边缘区B细胞淋巴瘤(MZL-MALT淋巴瘤)的临床和病理学特点. 方法 回顾分析9例胃发生粘膜相关淋巴组织结外边缘区B细胞淋巴瘤的临床资料、组织学特点,结合免疫组化标记以及幽门螺杆菌(Helicobacter pylori HP)感染情况进行综合分析.结果 胃MZL-MALT淋巴瘤临床表现与胃癌、胃炎相似.结论 胃MZL-MALT淋巴瘤是低度恶性B细胞淋巴瘤,胃镜活检结合免疫组化标记可以明确诊断,抗HP治疗有显著效果,结合放、化疗预后良好.     

免疫固定电泳技术在多发性骨髓瘤诊断及分型中的应用

[目的]探讨免疫固定电泳技术在多发性骨髓瘤(MM)诊断及分型中的应用.[方法]收集30例患有MM的患者的血清进行相关检测.免疫固定电泳采用美国海伦那电泳仪进行检测及扫描;免疫球蛋白定量及血轻链检测:用西门子BNⅡ免疫分析仪以全自动方式进行速率散射比浊分析对MM患者的血清中免疫球蛋白(IgG、IgA、IgM)含量及血轻链...     

A study of Hodgkin/Reed-Sternberg cells using single cell polymerase chain reaction

Objective To investigate the characteristics of Hodgkin/Reed- Sternberg (H/R-S) cells found in patients with various types of Hodgkin’s disease (HD). Methods H/R- S cells were micropicked from frozen sections of tissues affected by HD. The DNA from these cells was amplified by polymerase chain reaction (PCR) using immunoglobulin heavy chain gene FRⅢa/JH primers and light chain gene family- specific primers. Results A total of 52/135 (35. 8%) isolated cells showed the specific products in the reactions. IgH and V(κ4) rearrangements were repeatedly found in many cells from a lymphocyte predominance type sample; repeated V(κ4) and individual IgH/V(κ2,4) rearrangements and individual IgH, V(λ 3) / V(κ4) rearrangements were found in two different cases of the nodular sclerosis type; repeated IgH/ V(λ3) and individual V(λ2,4) rearrangements, repeated V(κ2,4) rearrangements, repeated V(κ4) and individual IgH/ V(κ3) rearrangements, repeated IgH and individual V(κ3) / V(λ4) rearrangements were detected in 3 cases of the mixed cellularity type. Repeated and individual IgH rearrangements were found in other 2 cases. Conclusion The H/R- S cells isolated from the lymphocyte predominance subtypes of HD have IgH and V(λ4) gene rearrangements. This suggests that the lymphocyte predominance type is a proliferation of neoplastic B cells. The cells isolated from the mixed cellularity and nodular sclerosis types derive from B lineage cells at various stages of differentiation because of the presence of their IgH, κ and/or λ gene rearrangements. To our knowledge, this is the first time that the λ gene rearrangement was detected in H/R- S cells.     

Rapid in-situ hybridization and immunohistochemistry: a pilot comparative study of two rapid diagnostic techniques for establishing monoclonality in plasma cell dyscrasias

BackgroundLight chain restriction needs to be established on the paraffin embedded tissue in certain types of plasma cell dyscrasias when serum levels of monoclonal immunoglobulins and light chain assays in the urine and serum may be normal. Rapid-in-situ-hybridisation (RISH) is thought to be a superior to immunohistochemistry (IHC) for kappa and lambda staining due to brighter and crisp staining without any background.MethodsFifty cases were included in this pilot study. Serum light chain restriction status of the case was taken as gold standard. The results of standard IHC for kappa and lambda immunoglobulins on the bone marrow biopsy of these cases was compared with RISH performed by the two commercially available kits. The results of the two methods were compared for sensitivity, need to repeat the test and background staining.ResultsThe study found that in IHC first run sensitivity was 58% which improved to 88% after the second run. For RISH the sensitivity was 100%.ConclusionRapid-in-situ-hybridisation (RISH) is a superior technique to IHC for detecting kappa and lambda light chain in plasma cells. The test is as labour intensive and time consuming as the routine IHC but has no background staining with more bright and crisp staining quality.     

血清Kappa与Lambda轻链的检测在恶性肿瘤中的表达

目的探讨血清中Kappa和Lambda轻链在恶性肿瘤患者中的表达情况。方法采用免疫比浊法对80例恶性肿瘤患者和20例健康体检者血清中Kappa和Lambda轻链进行检测。结果肝癌组患者血清中κ和λ值均显著高于健康对照组,且差异有统计学意义(P0.01);而κ/λ比值与健康对照组比较,差异无统计学意义(P0.05)。胃癌、肺癌、乳腺癌、食道癌、大肠癌组患者血清中κ、λ、κ/λ比值分别与健康对照组比较,差异均无统计学意义(P0.05)。结论血清中Kappa和Lambda轻链的测定,可作为原发性肝癌的诊断指标和对患者免疫功能的监测。     

急性肾炎患儿尿IgG轻链检测及其临床意义

目的:探讨急性肾炎患儿尿IgG轻链与临床的关系。方法:使用闪射比浊法研究急性肾炎患儿尿IgGKappa、lambda轻链急性期、恢复期与对照组的比较以及与临床的关系。结果:急性肾炎患儿尿IgGLambda轻链急性期、恢复期与对照组比较,差异无统计学意义。急性肾炎患儿尿kappa轻链急性期与恢复期及对照组差异有统计学意义(P<0.05)。尿kappa轻链与蛋白尿呈正相关。结论:尿IgGKappa轻链升高可作为急性肾炎患儿肾炎发生时的炎症反应指标及估计疾病程度和预后的指标。     

72例多发性骨髓瘤单克隆蛋白分析

Serum and urinary monoclonal proteins (M protein) were measured in 72 cases of multiple myeloma (MM) using rate nephelometry. In IgG and IgA types of MM, the level of immunoglobulin (Ig) corresponding to the malignant isotype was significantly higher and that of Ig uncorresponding to the malignant isotype lower than the normal level. The light chain corresponding to the malignant isotype in serum was increased and the light chain uncorresponding to that in serum was decreased either kappa-IgG, IgA types or lambda-IgG, IgA types. Either kappa-LC or lambda-LC type of MM, the serum light chain corresponding to the malignant isotype was in the normal range and uncorresponding to that was decreased, and the corresponding light chain in urine was significantly elevated. Kappa/lambda ratio in serum and urine was all significantly abnormal in IgG, IgA, and LC types of MM. Our data suggest that any quota among kappa light chain > 20 g.L-1 or < 5 g.L-1, lambda light chain > 10 g.L-1 or < 2 g.L-1 in serum and kappa/lambda ratio > 5 or < 0.75 in serum and urine has an important value for diagnosing MM.     

CLINICAL PATHOLOGICAL FEATURE OF EARLY TONGUE AMYLOIDOSIS

AMYLOIDOSIS (AL) is known as a disease thataffects almost all organs, and may especiallycause widespead damage to the tongue·1For thevariety of protein species involved and the wide spectrumof possible clinical presentations, tongue AL is frequentlyoverl…     

72例多发性骨髓瘤单克隆蛋白分析

用速率散射比浊法测定 72例多发性骨髓瘤 (MM)血清与尿中单克隆蛋白 (M蛋白 )。结果显示 ,与IgG型 ,IgA型对应的免疫球蛋白 (Ig)均显著增高 ,不对应的Ig均明显降低。无论κ或λIgG ,IgA型 ,其对应的血清轻链显著增高 ,不对应的血清轻链显著降低。无论LC κ或是LC λ型 ,对应的血轻链在正常范围 ,不对应的血轻链低于正常 ,而尿中对应的轻链显著增高。在IgG ,IgA ,LC三型中 ,血清与尿中轻链κ/λ均显著异常。提示 ,血清中κ轻链 >2 0g·L 1或 <5g·L 1,λ轻链 >10g·L 1或 <2g·L 1,血、尿中κ/λ >5或 <0 .75时 ,任一项指标对MM的诊断均具有重要价值。     

皖南地区336例恶性淋巴瘤回顾性病理分析

本文根据我国恶性淋巴瘤分类的修订洛阳方案对皖南地区1972-1982年336例恶性淋巴瘤进行了回顾性分析。发现其中非何杰金淋巴瘤325例(96.7％),何杰金氏病11例(3.3％)。非何杰金氏淋巴瘤中滤泡型19例(5.8％),弥漫型306例(94.2％),而弥漫型中以B细胞肿瘤(尤以滤泡中心细胞起源的肿瘤)占大多数(240例,73.8％)。T细胞肿瘤为54例(16.6％)。结果与国内各地的报告大致相同。本文还讨论了在应用修订洛阳方案进行恶性淋巴瘤分类过程中遇到的一些问题,着重指出对类型不同、大小不等起源于滤泡中心细胞的肿瘤如何结合其预后,归入适当的亚型是值得研究的问题。     

Cutaneous germinal center cell-derived lymphomas. A clinical histopathological and immunopathological study of 18 cases.

Eighteen cases of cutaneous germinal center cell-derived lymphomas (CGCCL) were classified into 3 types according to Kiel classification: centrocytic lymphomas (CC), 7; centroblastic-centrocytic lymphomas (CB/CC), 9; and centroblastic lymphomas (CB), 2. The duration of the disease was 3-14 months (median 9.5 months) after the first admission. In all cases, monomorphous cutaneous nodules were found as the initial manifestation of the disease. Twelve cases of CGCCL, especially those of CB and CB/CC, initially presented with normochromic anemia, a finding which is helpful in the diagnosis of the disease. Cytomorphologically, CB tumor cells were easily identified, white CC cells were hard to distinguish from the cells of nonepidermotropic cutaneous T cell lymphoma. In many cases, however, electron microscopic examination and cytochemical stains of skin biopsy tissue imprints are useful in diagnosing CGCCL. Immunoenzyme labelling (ABC method) with monoclonal antibodies indicated that B1, K and lambda positivity are very important markers for CGCCL. Our findings also showed a higher percentage of rK type in CGCCL as compared to the Western countries.