Reticulum cell neoplasms of lymph nodes - A clinicopathologic study of 11 cases with recognition of a new subtype derived from fibroblastic reticular cells
Reticulum cell neoplasms of lymph nodes - A clinicopathologic study of 11 cases with recognition of a new subtype derived from fibroblastic reticular cells
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DOI：
10.1097/00000478-199809000-00002
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发表时间：
1998-09-01
影响因子：
5.6
通讯作者：
Jaffe, ES
中科院分区：
文献类型：
--
作者：
Andriko, JAW;Kaldjian, EP;Jaffe, ES
淋巴结含有非淋巴辅助细胞，包括滤泡树突细胞 (FDC)、叉指树突细胞 (IDC) 和成纤维网状细胞 (FBRC)。 FDC 来源的肿瘤并不常见，而 IDC 来源的肿瘤则更为罕见。我们报告了 11 种网状细胞肿瘤的临床病理特征，其中 2 种是 FBRC 起源的。其中男性患者7名，女性患者4名，年龄从13岁到73岁不等。所有病例均累及淋巴结（颈部或锁骨上6例）、腹部（2例）、滑车上（1例）； 2 例有超过 1 个部位受累（颈部淋巴结和纵隔 1 例，颈部和腹部淋巴结 1 例）。 1 例 FDC 肿瘤伴有卡斯尔曼病（浆细胞变异型）。每种肿瘤均表现出相似的组织学，细胞呈席纹状或束状，呈椭圆形至纺锤形。根据免疫表型结果，肿瘤被分类为 FDC（5 例）。 LDC（两例）、FBRC（三例）和网状细胞肿瘤，未另外指定音调病例）。 FDC 肿瘤显示出对 CD21 或 CD35、波形蛋白和 CD68 的免疫反应性。 IDC 肿瘤显示 S-100 蛋白强阳性，CD68 和 CD1a 呈可变阳性。来自 FBRC 的病例呈波形蛋白、结蛋白和平滑肌肌动蛋白阳性。分类为网状细胞肿瘤的肿瘤（未另外指定）具有相似的形态学特征，但仅显示出 CD68 和波形蛋白的模棱两可的阳性结果。 11 例中有 9 例 (82%) 得到了随访，平均随访时间为 3.5 年。五名患有 FDC 肿瘤的患者最后一次就诊时，有四名患者还活着；第五个仍然活得很好，在 4 年的随访中没有任何疾病证据。一名 IDC 肿瘤患者在不同的淋巴结部位复发。两名 FBRC 肿瘤患者分别在 2 年和 8 年的随访中没有疾病。患有网状细胞肿瘤（未另有说明）的患者在诊断后 8 年内仍存活且无疾病。
Lymph nodes contain nonlymphoid accessory cells including Follicular dendritic cells (FDCs), interdigitating dendritic cells (IDCs) and fibroblastic reticular cells (FBRCs). Neoplasms derived from FDCs are uncommon, and those of IDC origin are even more rare. We report the clinicopathologic features of 11 reticulum cell neoplasms, including 2 of FBRC origin. There were seven male patients and four female patients ranging in age from 13 to 73 years. All cases involved lymph nodes (cervical or supraclavicular-6 cases), (abdominal-2 cases), epitrochlear (1 case); two had more than one site of involvement (cervical lymph node and mediastinum-1 case, cervical and abdominal lymph nodes-1 case). One case of FDC tumor had concomitant Castleman's disease, plasma cell variant. Each neoplasm showed similar histology with oval-to-spindle-shaped cells in a storiform or fascicular pattern. Eased on immunophenotypic findings, the neoplasms were classified as FDC (five cases). LDC (two cases), FBRC ((three cases), and reticulum cell neoplasm, not otherwise specified tone case). The FDC tumors showed immunoreactivity for CD21 or CD35, vimentin, and CD68. The IDC tumors showed strong positivity for S-100 protein and variable positivity for CD68 and CD1a. The cases derived from FBRCs were positive for vimentin, desmin, and smooth-muscle actin. The neoplasm classified as reticulum cell neoplasm, not otherwise specified had similar morphologic features but showed only equivocal positivity for CD68 and vimentin. Follow-up was available for 9 of 11 (82%) cases with a mean of 3.5 years. Four of five patients with FDC tumors were alive with disease when last seen; the fifth is alive and well with no evidence of disease at 4-year follow-up. One patient with IDC tumor had a recurrence in a different nodal site. Two patients with FBRC tumor were disease free at follow-up of 2 years and 8 years, respectively. The patient with reticulum cell neoplasm, not otherwise specified, was alive and disease free 8 years after diagnosis.