细针穿刺物细胞形态学与流式细胞学诊断非霍奇金淋巴瘤的意义  

Fine-needle aspiration in non-Hodgkin lymphoma:evaluation of cell size by cytomorphology and flow cytometry

作　　者：李晓兰[1] 许方[1] 马荣[1] 

机构地区：[1]大连医科大学附属二院检验科,大连116027

出　　处：《山西医科大学学报》2005年第6期726-728,共3页Journal of Shanxi Medical University

摘　　要：目的探讨是否可据细针穿刺物(FNA)的细胞形态学(CM)与流式细胞学(FCM)结果对大细胞淋巴瘤进行可靠的诊断。方法对36例非霍奇金淋巴瘤(NHL)的细针穿刺物标本和来自相同病理部位的外科活检组织的CM与FCM结果进行比较分析。CM结果通过检查每对标本中的200个淋巴细胞,FCM通过分析单核细胞群或者反常的B细胞群。结果小细胞非霍奇金淋巴瘤(NHL)的大细胞数CM与FCM结果都低于40%;弥散性的大细胞淋巴瘤的大细胞数CM结果100%(9/9),FCM结果77.7%(6/9),超过40%。TNMⅢ期分叶淋巴瘤,其他低分化淋巴瘤和少数大的B细胞淋巴瘤中发现超过10%的恶性细胞。结论通过合并使用CM和FCM,FNA能令人信赖地诊断弥散性的大细胞淋巴瘤,当大细胞数低于40%外科活组织检查是必要的。Objective To research whether a reliable diagnosis of large cell lymphoma could be made by fine-needle aspiration （FNA） specimens with initial cytomorphology （CM） and flow cytometry （FCM）. Methods Thirty-six non-Hodgkin lymphoma （NHL） were studied. CM was evaluated by examining 200 lymphocytes in each FNA specimen. FCM was performed by analyzing monoclonal or abnormal B-cell populations. Percentages of large cells were evaluated by CM and FCM. The results were compared with subsequent surgical biopsy of the same lesion. Results All small cell NHLs showed fewer than 40% large cells by CM and FCM;100% （9/9; FCM） and 77.7% （7/9;CM） of diffuse large B-cell lymphomas demonstrated greater than 40% large cells. Variable numbers of large cells were detected in grade Ⅲ follicular lymphoma, low-grade lymphoma with partial large cell transformation, and large B-cell lymphoma containing fewer than 10% neoplastic cells. Conclusion By using combined CM and FCM, large cell lymphoma can be diagnosed reliably by FNA if greater than 40 % large cells are present. Surgical biopsy is necessary when there is fewer than 40% large cells.

关 键 词：淋巴瘤 非霍奇金 细胞形态学 流式细胞学 细针穿刺物 

分 类 号：R733.1[医药卫生—肿瘤]