髓细胞核分化抗原在大疱性浆细胞树突状细胞瘤中的不同部位表达。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Philip L Bulterys, Atif Saleem, Ryanne A Brown, Roberto A Novoa, Kerri E Rieger, Yasodha Natkunam, Sebastian Fernandez-Pol
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引用次数: 0

摘要

研究目的大疱性浆细胞树突状细胞瘤(BPDCN)是一种罕见的侵袭性血液肿瘤,在临床、形态学和免疫表型上可与急性髓系白血病重叠。髓系细胞核分化抗原(MNDA)是一种由髓单核细胞表达的核蛋白,以前曾有报道称它在 BPDCN 中缺失,并被认为是区分 BPDCN 和急性髓系白血病的有效辅助指标。我们遇到的一例 BPDCN 患者在骨髓和乳腺样本中显示 MNDA 的强核表达,而在皮肤样本中则显示弱表达或无表达,这促使我们重新评估 MNDA 在 BPDCN 中的表达:方法:我们从斯坦福大学的档案中收集了过去 10 年中所有可用的 BPDCN 病例,并对它们进行了 MNDA 免疫组化。对部分病例进行了新一代测序的分子谱分析:结果:我们发现 4 例病例(共 8 例[50%])的 MNDA 表达存在令人信服的位点不一致。这种表达见于6份骨髓样本中的3份(50%)、2份乳腺软组织样本中的1份(50%)和14份皮肤样本中的3份(高达21%),而且与年龄、性别、髓样肿瘤病史或治疗史无明显关联。在2个病例中,MNDA在2个不同部位(乳腺/骨髓、皮肤/骨髓)强表达,而在随后的样本中则呈阴性:我们的研究结果表明,MNDA在BPDCN中的表达与解剖部位有关,并且是短暂的,非皮肤浸润比皮肤浸润的表达更频繁。这些结果提醒我们,在考虑髓外浸润的鉴别诊断时,不要使用 MNDA 来排除 BPDCN。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Site-discordant expression of myeloid cell nuclear differentiation antigen in blastic plasmacytoid dendritic cell neoplasm.

Objectives: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic neoplasm that can show clinical, morphologic, and immunophenotypic overlap with acute myeloid leukemia. Myeloid cell nuclear differentiation antigen (MNDA) is a nuclear protein expressed by myelomonocytic cells previously reported to be reliably absent in BPDCN and proposed as a useful adjunct for the distinction of BPDCN and acute myeloid leukemia. We encountered a case of BPDCN that showed strong nuclear expression of MNDA in bone marrow and breast samples and weak to absent expression in skin samples, prompting us to reevaluate the expression of MNDA in BPDCN.

Methods: We collected all available BPDCN cases from the Stanford University archives collected in the past 10 years and subjected them to MNDA immunohistochemistry. In select cases, molecular profiling by next-generation sequencing was performed.

Results: We found 4 cases (of 8 total examined [50%]) with convincing site-discordant MNDA expression. This expression was seen in 3 of 6 (50%) bone marrow samples, 1 of 2 (50%) breast soft tissue samples, and 3 of 14 (up to 21%) skin samples and was not obviously predicted by age, sex, history of myeloid neoplasm, or treatment history. In 2 cases, MNDA was strongly expressed in 2 distinct sites (breast/bone marrow, skin/bone marrow) and negative in subsequent samples.

Conclusions: Our findings suggest that MNDA expression in BPDCN is anatomic site dependent and transient, with noncutaneous infiltrates showing more frequent expression than cutaneous infiltrates. These results caution against the use of MNDA to exclude BPDCN when considering the differential diagnosis of a blastic extramedullary infiltrate.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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