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 cellsand NK-like T cells,Disc
2、repancy of CD3 expressionin NK cells,CD3 is a TCR-associated complexFormed by 6 chains:,2,2NK cells have cytoplasmic or,but cannot assemble intact CD3 complexConventional CD3 antibody detects chain“cytoplasmic CD3”,Surface CD3(as detected by Leu4/OKT3)by flow cytometry or on frozen tissue is NEGATIV
3、E,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 cytologic spectrum,Morphologic features,
4、Surface squamous epithelium can show florid pseudoepitheliomatous hyperplasiaEntrapped nasal mucosal glands often show clear cell changeSkin:infiltrate often perivascular and periadnexal,but sometimes diffuse dermal;subcutis can be involvedIntestine:Ulceration and perforation common,Skin,Intestine,T
5、estis,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:germline in most cases studied,EBVPresent in clonal episomal formNasal:95%posi
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