nk细胞淋巴瘤讲义-文档资料.ppt
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1、,包括: 结外NK/T细胞淋巴瘤,鼻型 侵袭性NK细胞白血病 慢性NK细胞淋巴增生性疾病,NK细胞的免疫表型特点,No single marker unequivocally identifies all NK cells,CD2 70-90% s-CD3 0% c-CD3 95% CD4 0% CD5 0% CD7 80-90% CD8 30-40%,CD11b* 80-90% CD16* 80-90% CD56* 95% CD57* 50-60% CD25 95%,* Commonly used NK markers, but expressed in both NK cells and
2、NK-like T cells,Discrepancy of CD3 expression in NK cells,CD3 is a TCR-associated complex Formed by 6 chains: , , 2, 2 NK cells have cytoplasmic or , but cannot assemble intact CD3 complex Conventional CD3 antibody detects chain “cytoplasmic CD3”,Surface CD3 (as detected by Leu4/OKT3) by flow cytome
3、try or on frozen tissue is NEGATIVE,TCR,Leu4, OKT3,结外NK/T细胞淋巴瘤,鼻型,a鼻腔、鼻咽部、鼻窦及腭部最常见,皮肤、软组织、胃肠道和睾丸亦常见。 b鼻腔者表现为鼻塞、鼻衄,粘膜坏死及溃疡。皮肤病变表现为结节并多伴有溃疡。发生在肠道者常发生穿孔。 c肿瘤常有噬血管性,多伴有血管破坏和坏死。 d常坏死明显,活检取材要取及非坏死瘤组织,常需多次取材才能确诊。,大多数病例为EBV(+)、CD56(+)的NK细胞表型,而少数病例具有EBV(+)、CD56(-)的细胞毒性T细胞表型。,Small,Medium-sized,Large,Broad cy
4、tologic spectrum,Morphologic features,Surface squamous epithelium can show florid pseudoepitheliomatous hyperplasia Entrapped nasal mucosal glands often show clear cell change Skin: infiltrate often perivascular and periadnexal, but sometimes diffuse dermal; subcutis can be involved Intestine: Ulcer
5、ation and perforation common,Skin,Intestine,Testis,Muscle,结外NK/T细胞淋巴瘤的免疫表型 CD2 + 表面 CD3 -; 胞浆 CD3 + (polyclonal CD3; PS1) CD56 +, CD57和CD16常- CD4, CD5, CD7, CD8: 常-,CD43, CD45RO: 常+ 细胞毒颗粒 + Ki67 : 高 CD25和 CD30偶尔+ TCR-;,CD3,CD5,CD56,Granzyme B,Extranodal NK/T cell lymphoma: Genotype,TCR genes: germli
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