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Scheda a cura di Marco Chilosi (GYM)
FASCIN
Applicazione
diagnostica nella diagnosi differenziale del linfoma di Hodgkin
L'utilizzazione immunoistologica diagnostica di anticorpi anti-fascin è
legata alla distinzione tra cellule atipiche (H-RS) del linfoma di Hodgkin
classico (che esprimono elevati livelli di fascin) e quelle della forma a
prevalenza linfocitaria (che non esprimono fascin).
Caso 1. HD "classic-type"
Intensa espressione citoplasmatica di fascin nelle cellule di H-RS e
nelle adiacenti cellule dendritiche.
Caso 2. HD "prevalenza linfocitaria"
Le cellule atipiche nel linfoma di Hodgkin a prevalenza linfocitaria sono
invece negative. Intensa espressione di fascin nel network formato dalle
cellule follicolari dendritiche adiacenti.
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- Am J Pathol 1997 Feb;150(2):543-62
Fascin, a sensitive new marker for Reed-Sternberg cells
of hodgkin's disease. Evidence for a dendritic or B cell derivation?
Pinkus GS, Pinkus JL, Langhoff E, Matsumura F, Yamashiro S, Mosialos G,
Said JW.
Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115,
USA.
Immunohistochemical localization of human fascin, a distinct 55-kd
actin-bundling protein, was determined for a wide variety of lymphoid
tissues (364 specimens total). In non-neoplastic tissues, reactivity was
highly selective and localized predominantly in dendritic cells. In the
thymus, this protein was distinctly localized to medullary dendritic cells.
In reactive nodes, interdigitating reticulum cells of T zones, cells in
subcapsular areas, and cells of the reticular network were reactive, with
variable reactivity observed for follicular dendritic cells. Splenic
dendritic cells of the white pulp and sinus-lining cells of the red pulp
were reactive. Endothelial cells of all tissues exhibited variable
reactivity. Lymphoid cells, myeloid cells, and plasma cells were uniformly
nonreactive. In the peripheral blood, only dendritic (veiled) cells were
reactive for fascin. A striking finding was observed for cases of Hodgkin's
disease (total 187 cases). In all cases of nodular sclerosis (132), mixed
cellularity (34), lymphocyte depletion (2), and unclassified types (5), all
or nearly all Reed-Sternberg cells and variants were immunoreactive for
fascin. Neoplastic cells exhibited strong diffuse cytoplasmic staining and
frequently assumed dendritic shapes, particularly in the nodular sclerosis
type, producing an interdigitating meshwork or syncytial network of cells.
In cases of mixed cellularity type, neoplastic cells generally appeared more
discrete. In all 14 cases of nodular lymphocyte predominance type, L&H
variants were nonreactive. By contrast, neoplastic lymphoid cells of only 24
of 156 (15%) other lymphoid neoplasms (127 B cell, 27 T cell, and two null
cell evaluated) were reactive for fascin. Fascin represents a highly
effective marker for detection of certain dendritic cells in normal and
neoplastic tissues, is an extremely consistent marker for Reed-Sternberg
cells and variants of Hodgkin's disease (except L&H types), and may be
helpful to distinguish between Hodgkin's disease and non-Hodgkin's lymphoma
in difficult cases. The staining profile for fascin raises the possibility
of a dendritic cell derivation, particularly an interdigitating reticulum
cell, for the neoplastic cells of Hodgkin's disease, notably in nodular
sclerosis type. However, as fascin expression may be induced by Epstein-Barr
virus infection of B cells, the possibility that viral induction of fascin
in lymphoid or other cell types must also be considered in Epstein-Barr
virus-positive cases.
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