颌骨郎格罕细胞组织细胞增生症的临床病理及免疫组化研究

目的研究慢性局限性郎格罕细胞组织细胞增生症（Ｌａｎｇｅｒｈａｎｓｃｅｌｈｉｓｔｉｏｃｙｔｏｓｉｓ，ＬＣＨ）的组织病理学及免疫组织化学特点。方法ＨＥ染色及组织学观察，有丝分裂计数和免疫组织化学染色。结果本项研究包括２２例ＬＣＨ。ＨＥ染色见郎格罕细胞（ＬＣ）核因扭曲而呈现多样性，核分裂并不少见（平均每１０个高倍视野７．１个核分裂像）。片状排列的细胞间可见明显不规则的细胞间隙。免疫染色见ＬＣＳ－１００阳性，增殖细胞核抗原（ＰＣＮＡ）阳性率平均为１４．５％，病变中还散在ＣＤ６８及组织蛋白酶Ｄ阳性的组织细胞，淋巴细胞以Ｔ细胞为主。结论上述结果提示，ＬＣ细胞核形态的多样性及细胞排列是诊断本病的基础；该病变的性质是ＬＣ增殖而不是ＬＣ单纯聚积，可能属于肿瘤性增生；病变中的ＬＣ属不成熟的ＬＣ前体细胞。

Langerhans cell histiocytosis of jaws: a clinical pathological and immunohistochemical study

Objective To investigate the pathological and immunohistochemical characteristics of chronic localized Langerhans cell histiocytosis (LCH). Methods HE staining and histopathological observation, mitotic counting and immunohistochemical staining. Results 22 cases of LCH were included in this study. The most prominent histologic feature was nuclear polymorphism of Langerhans cells (LC). Nuclear sulcus was often noted. Intercellular spaces were also obvious. Mitotic figures were commonly seen (the mean mitotic index was 7.1 under 10 high magnification fields). The mean PCNA index of LC was 14.5%. Other histiocytes and multinuclear cells were CD68 and cathepsin D positive. Conclusion The nuclear polymorphism of LC is of diagnostic value for LCH; LC in the lesions is hyperplastic and neoplastic in nature rather than simple accumulation and the S 100 positive LC are immature precursors of Langerhans cell.