A cytochemical and immunohistochemical approach to malignant histiocytosis
A cytochemical and immunohistochemical approach to malignant histiocytosis
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恶性组织细胞增多症的细胞化学和免疫组织化学方法
作者：
A. Carbone;C. Micheau;J. Caillaud;C. Carlu
恶性组织细胞增多症（MH）是一种真正的组织细胞疾病，其识别仍然基于过于宽泛的形态学标准。使用常规组织学、细胞化学和免疫组织化学技术对受累淋巴结进行了研究，对 15 例 MH 病例进行了研究。多形性和细胞异型性、吞噬作用、增殖细胞之间缺乏粘着性、血窦受累和浆细胞浸润是最常见的组织学特征。 14例的MGG染色印记显示复合肿瘤群主要由组织细胞样细胞、分化差的非典型细胞和多核巨细胞组成。这些细胞，无论细胞学特征如何，都显示出与酸性磷酸酶和非特异性酯酶的弥漫性中度至强阳性反应。萘酚-AS-D-氯乙酸酯酶、苏丹黑B、碱性磷酸酶和β-葡萄糖醛酸酶反应完全阴性。 11 例免疫过氧化物酶研究表明，肿瘤细胞的 kappa 链和 lambda 链均呈阳性染色。这些细胞的白蛋白也呈阳性。在两个病例中观察到 IgG 多型染色，在另外两个淋巴结中发现弱溶菌酶染色。总体结果证实了这些研究对于 MH 增殖细胞功能谱测定的价值。在 MH 中应常规考虑使用多种细胞化学和免疫组织化学技术的组合方法，作为有用的额外研究，以更精确地诊断该疾病。
Malignant histiocytosis (MH) is a true histiocytic disorder, whose identification is still based on too broad morphologic criteria. Using routine histology, cytochemical and immunohistochemical techniques on involved lymph nodes, 15 cases of MH have been investigated. Pleomorphism and cellular atypia, phagocytosis, lack of cohesiveness between proliferating cells, sinusoidal involvement, and plasmacytic infiltrate were the most common histologic features. MGG‐stained imprints from 14 cases showed a composite tumor population mainly consisting of histiocyte‐appearing cells, poorly differentiated atypical cells, and multinucleated giant cells. These cells, irrespective of cytologic features, revealed a diffuse, moderately to strongly positive reaction with acid phosphatase and nonspecific esterase. Naphtol‐AS‐D‐chloroacetate esterase, Sudan black B, alkaline phosphatase, and β‐glucuronidase reactions were completely negative. Immunoperoxidase studies in 11 cases demonstrated that tumor cells stained positively for both kappa and lambda chains. These cells were also positive for albumin. Polytypic staining for IgG was observed in two cases, and a weak staining for lysozyme was found in two other nodes. Global results confirm the value of these studies for functional profile determination of MH proliferating cells. A combined approach using a variety of cytochemical and immunohistochemical techniques should be routinely considered in MH as useful additional studies for a more precise diagnostic definition of the disease.