胸腹水恶性淋巴瘤细胞病理学形态分析及鉴别  

Cytopathological morphological analysis and identification of malignant lymphoma in pleural effusion and ascites

作　　者：康劲松[1] 马晓敏 马珩 颜芳 赵雅桐[1] 吴咪 雷清华 KANG Jinsong;MA Xiaomin;MA Heng;YAN Fang;ZHAO Yatong;WU Mi;LEI Qinghua(Surgical Cell Room of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;Dept.of Anatomy,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,Hubei,China;National Demonstration Center for Experimental Basic Medical Education of Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属同济医院外科细胞学诊断室,湖北武汉430030 [2]华中科技大学同济医学院基础医学院人体解剖学系,湖北武汉430030 [3]华中科技大学基础医学国家级实验室教学示范中心,湖北武汉430030

出　　处：《武汉大学学报（医学版）》2022年第4期634-638,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨胸腹水恶性淋巴瘤细胞病理学形态特征,积累诊断经验。方法:观察经组织病理学及流式细胞学证实的胸腹水中恶性淋巴瘤细胞病理学特征,结合临床病史、免疫组织化学结果进行分析。结果:本组37例患者,男性26例,女11例,胸水23例,腹水14例,细胞病理学明确诊断恶性淋巴瘤19例,可疑18例,经组织病理学、流式细胞学证实分型如下:弥漫大B细胞淋巴瘤19例,伯基特淋巴瘤4例,浆细胞瘤1例,间变大细胞淋巴瘤1例,外周T细胞淋巴瘤5例,T淋巴母细胞淋巴瘤2例,黏膜相关淋巴瘤,滤泡性淋巴瘤各1例。结论:掌握胸腹水中的恶性淋巴瘤的细胞病理学形态特征,注意鉴别诊断,不断积累经验,方能做出正确的诊断。在临床病史及细胞病理学基础上,结合细胞蜡块、免疫组织化学染色、重排及流式细胞学检查进一步确定淋巴瘤亚型。Objective:To explore the cytopathological features of malignant lymphoma in pleural effusion and ascites,and to accumulate diagnostic experience.Methods:The histopathological features of malignant lymphoma in pleural effusion and ascites confirmed by histopathology and flow cytometry were observed and analyzed in combination with clinical history and immunohistochemical results.Results:There were 37 patients,including 26 males and 11 females,23 pleural effusion and 14 ascites.19 cases of malignant lymphoma were diagnosed by cytopathology,and 18 cases were suspected.The classification was confirmed by histopathology and flow cytometry as follows:19 cases of diffuse large B-cell lymphoma,4 cases of Burkitt lymphoma,1 case of plasmacytoma,1 case of anaplastic large-cell lymphoma,5 cases of peripheral T-cell lymphoma,2 cases of T-lymphoblastic lymphoma,1 case of mucosa-associated lymphoma,and 1 case of follicular lymphoma.Conclusion:The correct diagnosis can be made by experienced doctors knowing well the cytopathological features of malignant lymphoma in pleural effusion and ascites and paying attention to differential diagnosis,and the further classification depends on immunohistochemical results and flow cytology.

关 键 词：胸腹水 恶性淋巴瘤 细胞病理学诊断 

分 类 号：R733[医药卫生—肿瘤]