兰格林
朗格汉斯细胞组织细胞增多症
病理
IRF4公司
组织细胞
滤泡增生
组织细胞增多症
医学
树突状细胞
朗格汉斯细胞
淋巴瘤
生物
免疫学
抗原
疾病
转录因子
生物化学
基因
作者
Sofía Garcés,Zbigniew Rudzki,C. Cameron Yin,Roberto N. Miranda,Ana Maria Medina,Vathany Sriganeshan,Branko Cuglievan,Shaoying Li,Jie Xu,Fatima Zahra Jelloul,Joseph D. Khoury,Beenu Thakral,Guilin Tang,Juan Carlos Garcés,L. Jeffrey Medeiros
标识
DOI:10.1097/pas.0000000000001935
摘要
Dermatopathic lymphadenopathy (DL) is a distinctive type of lymph node hyperplasia that typically occurs in the setting of chronic dermatologic diseases. DL generally self-resolves following disappearance of the underlying skin stimulus and does not require any specific therapy. We recently observed multiple myeloma oncogene 1/interferon regulatory factor 4 (MUM1/IRF4) expression in a case of DL using immunohistochemical methods. The goal of this study was to systematically assess DL cases for MUM1/IRF4 expression and to survey other histiocytic and Langerhans cell lesions. We particularly focused on Langerhans cell histiocytosis (LCH) because the differential diagnosis of DL versus LCH in lymph nodes can be challenging. We identified high expression of MUM1/IRF4 in all 22 cases of DL tested. Specifically, MUM1/IRF4+ dendritic cells comprised 50% to 90% (median, 80%) of all dendritic cells in the paracortex of dermatopathic lymph nodes, always showing moderate or strong intensity. Among 10 DL cases stained for MUM1/IRF4 and langerin/CD207 using dual immunohistochemistry, MUM1/IRF4+ and langerin+ Langerhans cells represented 5% to 60% (median, 30%) of paracortical dendritic cells. MUM1/IRF4 was also positive in reactive Langerhans cells in skin biopsy specimens of all cases of spongiotic dermatitis (n=10) and normal skin (n=15), and was negative in all cases of LCH (n=24), Rosai-Dorfman disease (n=10), follicular dendritic cell sarcoma (n=5) and histiocytic sarcoma (n=4). In aggregate, our findings support the utility of MUM1/IRF4 to highlight the dendritic cells of DL and to distinguish DL from other histiocytic and Langerhans cells lesions.
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