淋巴结细针穿刺标本的流式细胞术分析

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL     

急性髓系白血病细胞表面趋化因子受体CXCR4表达情况研究

摘要:目的　通过研究急性髓系白血病（AML）患者白血病细胞表面趋化因子受体CXCR4的表达情况,探讨CXCR4在AML中表达的意义。方法　收集初诊未治疗的130例AML患者,根据FAB分型标准进行分类,以急性淋巴细胞白血病（ALL）患者和非血液系统疾病患者作为对照,检测3组之间及不同FAB亚型之间CXCR4表达情况,分析CXCR4在白血病尤其是AML中表达的意义。结果　AML实验组和ALL对照组细胞表面CXCR4相对荧光强度明显高于非血液系统疾病对照组,且ALL对照组荧光强度最高（P＜0.05）。M3和M4/M5亚型组白血病细胞CXCR4 表达明显高于其他亚组（P＜0.05）。结论　CXCR4的高表达可能与白血病的发病、浸润及病情发展有关,可为预防白血病细胞迁移及髓外浸润,提高难治性AML疗效和减少AML复发等方面提供新的思路。     

淋巴结细针穿刺标本的流式细胞术分析

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL     

伴染色体三体异常的慢性中性粒细胞白血病1例

慢性中性粒细胞白血病（chronic neutrophilic leukemia，CNL）是一种少见的骨髓增殖性疾病，其主要特点表现为外周血和骨髓中中性粒细胞的过度增生，同时可伴有肝脾肿大，而细胞遗传学和分子生物学检查无Ph染色体及BCR／ABL融合基因。这种疾病迄今为止全世界报道的病例不超过150例，虽然伴有9号染色体三体异常的CNL国外有报道，但国内尚未见报道。我院近期诊断1例伴有9号染色体三体核型异常的CNL，现报告如下。     

原始自然杀伤细胞白血病一例及其实验室诊断

目的提高对原始自然杀伤（NK）细胞白血病实验室诊断的认识。方法报道1例原始NK细胞白血病,并就其实验室诊断进行讨论及文献复习。结果原始NK细胞白血病临床表现、形态学、免疫学表型有其特殊表现,实验室检查对其诊断具有重要意义。结论原始NK细胞白血病是一种临床少见血液系统肿瘤,其诊断需将临床表现与实验室检查结合起来。     

伴有9号染色体三体异常的慢性中性粒细胞白血病一例

患者,女,69岁。因感觉右下腹胀痛、乏力、消瘦、盗汗1个月,到当地医院就诊,血常规检查发现WBC 36.4×109/L,诊断为“急性阑尾炎”,于第2天行“阑尾切除术”,术中阑尾未见明显炎症改变,术后一直抗感染治疗,但其临床症状未缓解,白细胞计数持续在(23.7~35.6)×109/L。术后第10天B超显示肝、脾肿大。骨髓检查后考虑慢性粒细胞白血病(CML)。为明确诊断到我院门诊进一步检查。体格检查:一般情况好,体温36.8℃,全身浅表淋巴结不大,胸骨无压痛,心肺无明显异常,腹软,肝肋缘下4 cm,脾肋缘下13 cm,有明显压痛。血常规:WBC 27.6×109/L,中性分叶核…     

骨髓图像管理系统的设计与应用

近二十年来，计算机和信息技术已广泛应用于医学领域，成为医学迅速发展必不可少的工具。在现代化的临床医学实验室中，信息技术的使用尤为重要，很多医院已经建立了实验室信息系统（Labrotory Information System，LIS），以方便快速地处理各种数字和文字信息。在骨髓细胞形态学检验中，防工数字和文字之外，图形信息是俭验结果的重要组成部分。     

CAP细胞形态能力比对的实践与体会

美国病理家协会（The College of American Pathologists，CAP）1947年由一些致力于改进病理学和实验医学的病理学家们组建。能力比对试验（proficiency testing，PT）是CAP从事的主要活动项目之一，即将多份样本定期的、周期性的发送到参加实验室进行分析和／或鉴定，     

淋巴结细针穿刺标本的流式细胞术分析

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL