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Best practices in diagnostic immunohistochemistry: workup of cutaneous lymphoid lesions in the diagnosis of primary cutaneous lymphoma.

原发性皮肤淋巴瘤诊断中皮肤淋巴病变概述:诊断免疫组化中的最佳实践

Dewar R,Andea AA,Guitart J,Arber DA,Weiss LM

Abstract

Context .- Primary cutaneous lymphoma is a common extranodal non-Hodgkin lymphoma. These lesions share common features with their nodal counterparts, but also have differences in morphology, unique clinical presentations, and immunohistochemical features. Objective .- To review the 2008 World Health Organization (WHO) and 2005 consensus WHO-EORTC (European Organisation for Research and Treatment of Cancer) classifications, and address the immunohistochemical findings in the most common primary cutaneous T- and B-cell lymphomas. Since clonality testing is commonly used as an ancillary test in the evaluation of cutaneous lymphoma, a brief section in the use and pitfalls of clonality testing is included. Data Sources .- The WHO and EORTC classification publications and the relevant recent literature were used to compile appropriate and practical guidelines in this review. Conclusions .- The practice of dermatopathology and hematopathology varies widely. Thus, while this review provides an overview and guideline for the workup of lymphoid lesions of the skin, the practitioner should understand the importance of clinical correlation as well as appropriate utility of available resources (such as clonality testing) in arriving at a diagnosis in cutaneous lymphoid lesions.

摘要

原发性皮肤淋巴瘤为常见的结外非霍奇金淋巴瘤。这些病变与结内相对应病变具有相同点,但在形态学、独特的临床表现和免疫组织化学方面又有不同之处。目的:根据2008年世界卫生组织(WHO)和2005年WHO-EORTC(欧洲癌症研究和治疗组织)分类,对最常见的皮肤原发性T和B细胞淋巴瘤进行回顾,并着重于免疫组织化学结果。鉴于克隆性分析常被用作评价皮肤淋巴瘤的辅助检查,本文还包括概要介绍克隆性分析的使用以及陷阱。数据来源:WHO和EORTC分类文章及近期相关资料。结论:皮肤病理学和造血系统病理学有很大的差异。所以,尽管这篇文章介绍了皮肤淋巴病变的综述和指南,病理医生们还是要掌握临床病理联系,以及恰当合理地使用辅助检查(如克隆性分析),这样才能够正确地诊断皮肤淋巴病变。

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