γ-Synuclein Is a Promising New Marker for Staining Reactive Follicular Dendritic Cells, Follicular Dendritic Cell Sarcoma, Kaposi Sarcoma, and Benign and Malignant Vascular Tumors

Synucleins are small soluble proteins found in normal brain that facilitate rapid release of neurotransmitters. alpha-synuclein is a major component of the Lewy body of neurodegenerative diseases and gamma-synuclein is a marker of aggressive carcinomas. As the role of gamma-synuclein has not yet been investigated in the lymphoid system, we immunohistochemically stained normal lymphoid organs, lymph nodes with reactive lymphoid hyperplasia, and malignant lymphomas. The anti-g-synuclein antibody strongly stained the follicular dendritic cell (FDC) meshworks and vascular and lymphatic endothelial cells in reactive lymphoid tissues, in B-cell lymphomas with a nodular pattern, and in angioimmunoblastic T-cell lymphomas. There were no gamma-synuclein-positive FDC meshworks in B-cell or T-cell lymphomas with a diffuse pattern. This is in contrast to CD21, which only stained the arms of the FDCs; gamma-synuclein highlighted both the long slender cellular processes and the cell body, thereby clearly demonstrating the number of individual FDCs. In addition, gamma-synuclein was strongly expressed by the neoplastic counterpart of reactive FDCs (FDC sarcoma) and by the neoplastic counterparts of normal lymphatic and vascular endothelial cells (Kaposi sarcoma, hemangioma, and angiosarcoma). Only a few spindle cell neoplasms (SSNs) derived from smooth muscle, peripheral nerve, or gastrointestinal stroma expressed gamma-synuclein; however, gamma-synuclein was not expressed by 11 other types of SSNs tested. These results suggest that gamma-synuclein is a promising new adjunct marker for identifying reactive FDCs and for diagnosing FDC sarcoma and benign and malignant vascular tumors.