Rozasea, diskoid lupus eritematosus ve polimorf ışık erüpsiyonu lezyonlarının morfolojik ve immunhistokimyasal (CD4/CD8 T hücre ve CD123(+) plazmositoid dentritik hücre oranları) açıdan karşılaştırmalı analizi
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Tarih
2021
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Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Özet
Histopatolojik olarak benzer bulgular içeren Polimorf Işık Erüpsiyonu (PIE), Diskoid Lupus Eritematozus ve Rozasea vakalarında histopatolojik analiz ile birlikte immünohistokimyasal olarak CD123 oranı ile plazmositoid dentritik hücre (PDH) varlığının ve lenfositlerdeki CD4/CD8 oranlarının karşılaştırılması, böylece doğru tanıya ulaşmada immünohistokimyanın katkısının araştırılması ve literatüre katkı sağlanmasını amaçladık. Yöntem: 2015-2020 yılları arasında Meram Tıp Fakültesi Patoloji Anabilim Dalı laboratuarında incelenerek tanı almış 27 adet DLE, 27 adet PIE ve 29 adet Rozasea olgusuna ait preparatlar histopatolojik olarak tekrar gözden geçirildi. Parafin bloklardan kesitler alınarak, immunohistokimyasal boyama cihazında CD4, CD8 ve CD123 boyamaları yapıldı, lezyonlardaki lenfositik infiltrasyonların CD4/CD8 oranları ve CD123 pozitif PDH oranları değerlendirildi. Sonuçlar hasta gruplarına göre listelenip istatistiksel olarak uyumluluk ve farklılıklar ortaya konuldu. Bulgular: İstatistiksel sonuçlarda histopatolojik bulgulardan olan folliküler plugging, Demodeks varlığı, ödem, spongioz, müsin birikimi, bazal membran kalınlaşması açısından vakalar arasında anlamlı fark tespit edildi (sırasıyla; p=0,003; p=<0,001; p=0,001; p=0,027; p=<0,001; p=<0,001). Demodeks varlığı Rozasea'da PIE ve DLE'ye göre, ödem ve spongioz PIE'de DLE'ye göre, folliküler plugging DLE ve Rozasea'da PIE'ye göre, müsin birikimi ve bazal membran kalınlaşması DLE'de Rozasea ve PIE'ye göre anlamlı olarak daha fazla izlendi. İmmunhistokimyasal bulgulardan CD123 oranları açısından vaka grupları arasında istatiksel olarak anlamlı fark tespit edildi (p=0,006). Vakalarda izlenen CD123 oranları açısından bu anlamlılık değeri Rozasea ve DLE arasından kaynaklandığı (p=0,005) izlendi. Buna göre DLE'de CD123+ plazmositoid dentritik hücre oranları Rozasea'ya göre anlamlı derecede yüksek bulundu. Ayrıca en az CD123+ 20 hücreli grup içeren vaka sayıları açısından anlamlı bir fark tespit edildi (p=0,005). Bu anlamlı farkı DLE'de PIE ve Rozasea'ya göre daha fazla en az CD123+ 20 hücreli grup içermesi oluşturmaktadır. CD4/CD8 oranları açısından vaka v grupları arasında istatiksel olarak anlamlı fark tespit edilmedi (p=0,058). P değerinin 0.05'in hafif üstünde olması dikkati çekti. Sonuç: Bu çalışmamızda DLE, PIE ve Rozasea vakalarında histopatolojik ayrımda folliküler plugging, Demodeks varlığı, ödem, spongioz, müsin birikimi, bazal membran kalınlaşması gibi histolojik bulguların vurgulanması yanısıra histopatolojik ayrımda zorlandığımız vakalarda immunhistokimyasal bulgulardan CD123 oranının DLE ile Rozasea ayrımında bir seçenek olarak kullanılabileceği kanaatine varılmıştır. Yine en az CD123+ 20 hücreli grup içerip içermemesi DLE'yi PIE ve Rozasea'dan ayırımında kullanılabileceği düşünülmüştür.
Rosacea, discoid lupus erythematosus (DLE) and Polymorphic Light Eruption (PLE) are lesions with similar findings both clinically and histopathologically. In this study, we aimed to compare the immunohistochemically CD123 ratio with the presence of PDH and CD4 / CD8 ratios in lymphocytes with histopathological analysis in all three lesions, thus investigating the contribution of immunohistochemistry in reaching the correct diagnosis and contributing to the literature. Method: The preparations of 27 DLE, 27 PLE and 29 Rosacea cases who were examined and diagnosed in the laboratory of the Department of Pathology of Meram Medical Faculty between 2015-2020 were reviewed histopathologically. Sections were taken from the paraffin blocks, CD4, CD8 and CD123 staining was performed on an immunohistochemical stainer, CD4 / CD8 ratios of lymphocytic infiltrations in the lesions and CD123 positive PDH rates were evaluated. Results were listed according to patient groups and statistical consistency and differences were revealed. Results: In the statistical results, a significant difference was found between the cases in terms of histopathological findings such as follicular plugging, presence of demodex, edema, spongiosis, mucin accumulation, basement membrane thickening (respectively; p = 0.003; p = <0.001; p = 0.001; p = 0.027; p = <0.001; p = <0.001). Demodex presence was significantly more observed in Rozasea than in PLE and DLE, edema and spongiosis in PLE than in DLE, follicular plugging in DLE and Rozasea than in PLE, mucin accumulation and basal membrane thickening were significantly more observed in DLE than in Rozasea and PLE. A statistically significant difference was found between the case groups in terms of CD123 rates among immunohistochemical findings (p = 0.006). It was observed that this significance value in terms of CD123 rates observed in cases originated from Rosacea and DLE (p = 0.005). Accordingly, the rates of CD123 + plasmacytoid dendritic cells in DLE were found to be significantly higher than Rosacea. In addition, a significant difference was vii found in terms of the number of cases with at least CD123 + 20 cell groups (p = 0.005). This significant difference is due to the fact that it contains more CD123 + 20-cell groups in DLE than PLE and Rosacea. There was no statistically significant difference between the case groups according to the order of CD4 / CD8 (p = 0.058). It was noteworthy that the p value was slightly above 0.05. Conclusion: In this study, in the histopathological distinction of DLE, PLE and Rosacea cases, in addition to emphasizing histological findings such as follicular plugging, presence of Demodex, edema, spongiosis, mucin accumulation, basement membrane thickening, it was concluded that the CD123 ratio from immunohistochemical findings can be used as an option in distinguishing DLE from Rosacea. It is thought that whether it contains at least CD123 + 20-cell group or not can be used to distinguish DLE from PLE and Rosacea.
Rosacea, discoid lupus erythematosus (DLE) and Polymorphic Light Eruption (PLE) are lesions with similar findings both clinically and histopathologically. In this study, we aimed to compare the immunohistochemically CD123 ratio with the presence of PDH and CD4 / CD8 ratios in lymphocytes with histopathological analysis in all three lesions, thus investigating the contribution of immunohistochemistry in reaching the correct diagnosis and contributing to the literature. Method: The preparations of 27 DLE, 27 PLE and 29 Rosacea cases who were examined and diagnosed in the laboratory of the Department of Pathology of Meram Medical Faculty between 2015-2020 were reviewed histopathologically. Sections were taken from the paraffin blocks, CD4, CD8 and CD123 staining was performed on an immunohistochemical stainer, CD4 / CD8 ratios of lymphocytic infiltrations in the lesions and CD123 positive PDH rates were evaluated. Results were listed according to patient groups and statistical consistency and differences were revealed. Results: In the statistical results, a significant difference was found between the cases in terms of histopathological findings such as follicular plugging, presence of demodex, edema, spongiosis, mucin accumulation, basement membrane thickening (respectively; p = 0.003; p = <0.001; p = 0.001; p = 0.027; p = <0.001; p = <0.001). Demodex presence was significantly more observed in Rozasea than in PLE and DLE, edema and spongiosis in PLE than in DLE, follicular plugging in DLE and Rozasea than in PLE, mucin accumulation and basal membrane thickening were significantly more observed in DLE than in Rozasea and PLE. A statistically significant difference was found between the case groups in terms of CD123 rates among immunohistochemical findings (p = 0.006). It was observed that this significance value in terms of CD123 rates observed in cases originated from Rosacea and DLE (p = 0.005). Accordingly, the rates of CD123 + plasmacytoid dendritic cells in DLE were found to be significantly higher than Rosacea. In addition, a significant difference was vii found in terms of the number of cases with at least CD123 + 20 cell groups (p = 0.005). This significant difference is due to the fact that it contains more CD123 + 20-cell groups in DLE than PLE and Rosacea. There was no statistically significant difference between the case groups according to the order of CD4 / CD8 (p = 0.058). It was noteworthy that the p value was slightly above 0.05. Conclusion: In this study, in the histopathological distinction of DLE, PLE and Rosacea cases, in addition to emphasizing histological findings such as follicular plugging, presence of Demodex, edema, spongiosis, mucin accumulation, basement membrane thickening, it was concluded that the CD123 ratio from immunohistochemical findings can be used as an option in distinguishing DLE from Rosacea. It is thought that whether it contains at least CD123 + 20-cell group or not can be used to distinguish DLE from PLE and Rosacea.
Açıklama
Anahtar Kelimeler
Cd4/cd8, Diskoid lupus eritematozus, Polimorf ışık erüpsiyonu, Rozasea, cd123, Cd4/cd8, Discoid lupus erythematosus, Polymorphic light eruption, Rosacea
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Künye
Kızıltan, Ö. (2021). Rozasea, diskoid lupus eritematosus ve polimorf ışık erüpsiyonu lezyonlarının morfolojik ve immunhistokimyasal (CD4/CD8 T hücre ve CD123(+) plazmositoid dentritik hücre oranları) açıdan karşılaştırmalı analizi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Tıbbi Patoloji Anabilim Dalı, Konya.
