リンパ増殖性疾患に対する免疫組織化学染色

Immunohistochemical Diagnosis of Gastrointestinal Lymphoma

要旨●リンパ腫の診断はHE染色標本による組織および細胞観察と免疫染色との組み合わせが基本である．WHO分類でのリンパ腫の亜型が多岐にわたり，それぞれの診断に必要な免疫染色を掛け合わせるとその数は膨大な量となる．やみくもに免疫染色の数を増やしても診断にたどり着くわけではない．リンパ増殖性疾患については2016年にその概要がBlood誌上に示されたが，これまで以上に遺伝子異常が診断名に盛り込まれるようになった．つまり，形態と免疫染色だけでは現行のWHO分類に準じた診断名には至らないことがあることを意味する．本稿では消化管に発生するリンパ腫に対象を絞り，診断に必要な免疫染色について概説を行う．

　The diagnosis of lymphoma is based on the combined findings of HE staining and immunostaining of the specimen. Although the use of immunostaining is blindly increasing, it is difficult to make a specific diagnosis because of the presence of a wide variety of lymphoma subtypes in the WHO classification. Although publishing a“Blue Book”has been planned for aiding the diagnosis of lymphoma, its release has not yet been finalized. In 2016, its outline was published in the Bood journal. Genetic abnormalities have been specifically included in the diagnosis ; i.e., assessing only the morphology and immunostaining of the lymphoma may not lead to its diagnosis, according to the next WHO classification. In this manuscript, we focus on lymphomas occurring in the gastrointestinal tract and outline the immunostaining required for their diagnosis.