细针针吸细胞学在淋巴瘤诊断中的应用

 目的 探讨霍奇金氏淋巴瘤（HL）和非霍奇金氏淋巴瘤（NHL）针吸穿刺的敏感性，及淋巴瘤在针吸细胞学中容易产生的错误诊断。方法 对细针针吸细胞学诊断的318例HL和NHL与组织病理学结果对比。结果 淋巴瘤的敏感性为95．6％，HL的敏感性为93．7％，NHL的敏感性为96．1％。69例HL中误诊为NHL3例，反应性增生1例。NHL容易与HL及小细胞肿瘤混淆，包括小细胞癌，不典型类癌，胚胎性横纹肌肉瘤等。249例NHL中，6例误诊为HL，其中2例弥漫大B，2例富于T的B细胞淋巴瘤，1例滤泡中心型，1例为大细胞间变。免疫细胞化学结果与病理结果均一致。结论 针吸细胞学可以对淋巴瘤作出准确诊断，但应该做到多点针吸使标本满意，并要结合临床资料，免疫细胞化学可以作为淋巴瘤细胞学诊断的辅助手段。

The Application of Needle Aspiration Cytopathology in the Lymphoma Diagnosis

Objective The purpose of this paper was to discuss the sensitivity of Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma(NHL) in fine needle aspiration cytopathology and to discuss erroneous diagnosis which is regularly met in clinical cytology. Methods To compare 318 lymphoma cases' cytopathology with histopathology. Results The sensitivity of lymphoma is 95.6% and that of HL and NHL are 93.7%,96.1% respectively. Of the 69 HL cases, 3 cases were incorrectly diagnosed as NHL and 1 case was incorrectly diagnosed as reactive hyperplasia. We found that NHL was usually confused with small-cell tumors such as small-cell cancer, non-typical carcinoid, embryonal rhabdomyosarcoma etc. Of the 249 NHL cases, 6 were incorrectly diagnosed as HL, including two dispersed large-cell B, two T cell-rich B cell lymphoma, and one follicular lymphoma, one anaplastic large cell lymphoma. The results of immunocytochemistry and histopathology are consistent.Conclusion Fine needle aspiration cytopathology may work well to precisely diagnose lymphoma. In order to obtain satisfied samples, it is highly recommended that these samples should be aspirated at multiple locations and make best use of other clinical materials. Immunocytochemistry can become a auxiliary method in cytopathology diagnosis.