Contribution of flow cytometry in the diagnosis of cutaneous lymphoid lesions.
Contribution of flow cytometry in the diagnosis of cutaneous lymphoid lesions.
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流式细胞术在皮肤淋巴病变诊断中的贡献。
DOI：
10.1046/j.1523-1747.2003.12631.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Al-Saleem,Tahseen
中科院分区：
文献类型：
--
作者：
Wu,Hong;Smith,Mitchell;Millenson,MichaelM;Nicolaou,Nicos;VanDeerlin,ViviannaM;Addya,Kathkali;Lessin,Stuart;Al-Saleem,Tahseen
皮肤淋巴样病变的组织学诊断仍然是皮肤病理学中最具挑战性的领域之一，并且通过结合免疫表型和基因型数据来增强。为了改进对表面Ig轻链表达的分析，并提高从皮肤活检中获得的免疫表型数据的产量，我们评估了流式细胞术在皮肤淋巴浸润中的应用。流式细胞术免疫表型分析进行了19例患者的皮肤标本作为诊断程序的一部分。我们发现皮肤活检标本，包括常规穿刺活检，可为流式细胞术诊断提供足够的材料。一例反应性淋巴样增生显示多克隆B细胞，未见异常T细胞群。流式细胞术检测到Ig轻链限制，88%（15 / 17）的皮肤原发性或继发性B细胞淋巴瘤被用于诊断，相比之下，免疫组织化学诊断为37%（3 / 8）。近三分之一的病例在组织学上是可疑的，但由于加工伪影，混合细胞浸润或异常细胞的缺乏而难以病变。通过流式细胞术分析15个标本的其他标记物（3-23），并有助于淋巴瘤的亚分类。我们的经验表明，流式细胞术可以成功地应用于常规皮肤活检，有助于皮肤淋巴病变的诊断和亚分类。
The histologic diagnosis of cutaneous lymphoid lesions remains one of the most challenging areas of dermatopathology and is augmented by incorporation of immunophenotypic and genotypic data. To improve the analysis of surface Ig light chain expression and to increase the yield of immunophenotypic data obtained from skin biopsies, we evaluated the utility of flow cytometry in cutaneous lymphoid infiltrates. Flow cytometric immunophenotypic analyses were performed on skin specimens of 19 patients as a part of diagnostic procedures. We found that skin biopsy specimens, including a routine punch biopsy, yield sufficient material for diagnostic flow cytometry. One reactive lymphoid hyperplasia showed polyclonal B cells and no aberrant T cell populations. Ig light chain restriction was detected by flow cytometry and contributed to the diagnosis in 88% (15 of 17) of cutaneous primary or secondary B cell lymphomas, compared to 37% (three of eight) by immunohistochemistry. Nearly one-third of these cases were histologically suspicious but difficult lesions due to processing artifact, mixed cellular infiltrate, or paucity of abnormal cells. Additional markers (3–23) were analyzed by flow cytometry on 15 specimens, and contributed to subclassification of the lymphomas. Our experience demonstrates that flow cytometry can be successfully applied to routine skin biopsies and contributes to the diagnosis and subclassification of cutaneous lymphoid lesions.
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