Morphological and immunohistochemical clues for the diagnosis of cutaneous leishmaniasis and the interpretation of CD1a status

作者：Fernandez Flores Angel^*; Luis Rodriguez Peralto Jose

来源：Journal of the American Academy of Dermatology, 2016, 74(3): 536-543.

DOI：10.1016/j.jaad.2015.09.038

• amastigotes
• antigen transfer
• CD1a
• granuloma
• granulomatous inflammation
• Langerhans cell
• langerin
• Leishmania
• Leishmania infantum
• Leishmania major
• Leishmania tropica
• leishmaniasis
• MTB1
• transepidermal elimination

Background: CD1a immunoexpression by amastigotes of Leishmania major and L tropica has been demonstrated.
Objective: We studied the CD1a and the langerin status of amastigotes in cases of L infantum.
Methods: We investigated 19 cases of cutaneous leishmaniasis. All cases were immunostained with CD1a, langerin, and CD68. We also studied 4 cases of visceral leishmaniasis.
Results: We found expression of CD1a by amastigotes in all of these 19 cases. CD1a(-) amastigotes are found in reticular areas of the dermis. The pattern of CD1a immunostaining of amastigotes is characteristic, with peripheral positivity, a negative nucleus in the center, and reinforcement of the kinetoplast in 1 pole. Leishmania amastigotes were langerin-negative. Visceral Leishmania amastigotes also express CD1a.
Limitations: Our study was limited because it only included cases of infection by L infantum.
Conclusions: (1) L infantum is CD1a(+), (2) the pattern of CD1a immunostaining of amastigotes is peculiar, (3) CD1a(-) amastigotes are found in reticular areas of the dermis, and (4) visceral Leishmania amastigotes also express CD1a.

• 出版日期2016-3