皮肤假性淋巴瘤免疫组织化学与基因重排的检测

摘要 目的: 探讨皮肤假性淋巴瘤（CPL）的组织病理、免疫组化及基因重排特点。方法: 对28例皮肤假性淋巴瘤的石蜡包埋组织采用苏木素-伊红（HE）染色法进行组织病理学检查，应用免疫组化二步法检测皮损中CD3、CD20和CD45RO的表达情况，并应用PCR进行TCR-γ和IgH基因重排的检测。对照组为10例扁平苔藓患者。结果: 28例CPL组织病理显示真皮浅层内大量淋巴细胞浸润，免疫组化结果显示28例皮肤假性淋巴瘤皮损中以CD3及CD45RO阳性表达为主的共13例，为T细胞假性淋巴瘤；以CD20阳性表达为主的共15例，为B细胞假性淋巴瘤。28例CPL中TCR-γ基因重排时，无1例重排阳性，8例出现smear带，20例重排阴性。IgH基因重排时，1例出现smear带，余均为重排阴性。结论: 皮肤假性淋巴瘤组织真皮浅层内大量淋巴细胞浸润，主要是表达了CD3、CD45RO的T细胞，和表达CD20的B细胞；TCR-γ和IgH基因重排检测在鉴别CPL良恶性方面具有参考意义。

Immunohistochemistry and Gene Rearrangement in Cutaneous Pseudolymphomas

Abstract Objective: To study the characteristics of the cutaneous pseudo lymphomas（CPL） in histopathology, immunohistochemistry and gene rearrangement. Methods: Using HE staining method to proceed histopathological examination on 28 paraffin-embedded CPL tissues. The expression of CD3、CD20 and CD45RO in these tissues is also detected by two-step immunohistochemistric method and the gene rearrangement of TCR-γand IgH are tested by Polymerase Chain Reaction（PCR）. 10 cases of lichen planus（LP）lesions as control group are chosen in these experiment . Results: In the aspect of histopathology, the tissues of 28 CPL skin lesion in patie nt group revealed plenty of lymphocytic infiltration in the shallow lay of dermis. The result of immunohistochemistry indicate that among 28 cases in patient group,there were 13 cases with mainly positive expression of CD3 and CD45RO which have no statistical significance compared with the control group. Other 15 cases have the mainly positive expression of CD20 and are statistically different compared with the control group. On the other hand, none TCR-γgene rearrangement show positivity. 20 cases of rearrangement express negative, 8 cases appear smear band. For the gene rearrangement of IgH, most of them expressed negative except 1 case appearing smear band. Conclusion: The partial pathological lymphoid infiltration in the CPL skin lesion are T cells with the expression of CD3 and CD45RO, while others lymphoid infiltration are B cell with the expression CD20. The detection of TCR-γand IgH gene rearrangement have a important reference value for the diagnosis of malignancy status of CPL.