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运用细胞形态学免疫化学及流式细胞术快速

标题

PrecursorT-lymphoblasticlymphoma:SpeedydiagnosisinFNAandeffusioncytologybymorphology,immunochemistry,andflowcytometry.

运用细胞形态学、免疫化学及流式细胞术快速诊断FNA和积液细胞学中前驱T淋巴母细胞性淋巴瘤

原作者

BhakerP,DasA,RajwanshiA,GautamU,TrehanA,BansalD,VarmaN,SrinivasanR

译者

李国霞医院病理科

来源

华夏病理学网

期刊目录

CancerCytopathology;SeptemberVolume,Issue9:-65

摘要

前驱T淋巴母细胞性淋巴瘤(T-LBL)是一种少见的淋巴瘤,好发于儿童和青少年,临床表现为快速增长的纵膈肿块、呼吸困难和颈部淋巴结肿大,需要快速做出诊断。本研究旨在报道其细胞形态学和流式细胞术免疫表型(FCI)谱系。本文复习了-年所有确诊为T-LBL病例的临床表现、细胞形态学特征、FCI和细胞块免疫细胞化学(CB-ICC)检测结果。

共评估了15例前驱T-LBL(10例细针穿刺标本和5例胸腔积液/心包积液标本)。细胞学涂片显示淋巴母细胞散在分布,核浆比高,胞质稀少,嗜碱性。核显示核切迹、核裂、核凹痕。小至中等的淋巴母细胞染色质凝集,较大的淋巴母细胞染色质分散。仅较大的淋巴母细胞见核仁。镜影细胞及核分裂象多少不一。至于免疫表型,流式细胞术显示阳性的有:CD2(15/15)、CD3细胞膜(14/15)、CD3胞质(15/15)、TdT(8/15)、CD5(13/15)、CD10(7/15)以及人类白细胞抗原-DR(1/15)。肿瘤细胞团簇状紧密排列、皮质型T-LBL表现的所有病例显示CD4和CD8双阳性。CB-ICC显示免疫表型一致:CD3阳性、TdT阳性、CD20阴性。有7个病例,流式细胞术检测TdT阴性,而CB-ICC显示TdT阳性。

联合运用细胞形态学和FCI能准确并快速诊断细针穿刺和积液细胞学标本中的T-LBL,从而不需要活检。

Abstract

PrecursorT-lymphoblasticlymphoma(T-LBL)isararelymphomapresentingclinicallyinchildrenandadolescentswitharapidlyenlargingmediastinalmass,dyspnea,andcervicallymphadenopathyrequiringquickdiagnosis.Theobjectiveofthecurrentstudywastoreportonthespectrumofcytomorphologyandflowcytometricimmunophenotyping(FCI).

Theclinicalprofile,cytomorphologicalfeatures,FCI,andcellblockimmunocytochemistry(CB-ICC)ofallcasesofT-LBLdiagnosedfromthroughwerereviewed.

FifteencasesofprecursorT-LBL(10fine-needleaspirationsamplesand5pleural/pericardialfluidsamples)wereevaluated.Smearsdemonstrateddispersedlymphoblasts,withahighnuclear:cytoplasmicratioandscantybasophiliccytoplasm.Nucleidemonstratednotches,clefts,andindentations.Thechromatinwascondensedinsmallandintermediate-sizedblastsanddispersedinlargerblasts.Nucleoliwerepresentonlyinthelargerblasts.Handmirror-shapedcellsandmitoseswerevariable.Withregardtoimmunophenotyping,flowcytometrydemonstratedpositivityforCD2(15of15cases),surfaceCD3(14of15cases),cytoplasmicCD3(15of15cases),terminaldeoxynucleotidyltransferase(TdT)(8of15cases),CD5(13of15cases),CD10(7of15cases),andhumanleukocyteantigen-Drelated(HLA-DR)(1of15cases).DualCD4/CD8positivitywasobservedinallcasesformingatightcluster,whichisconsistentwiththecorticalT-LBLsubtype.CB-ICCdemonstratedauniformCD3-positive/TdT-positive/CD20-negativephenotype.In7casesinwhichTdTwasnegativebyflowcytometry,CB-ICCwaspositive.

CombiningcytomorphologyandFCIenablestheaccurateandrapiddiagnosisofT-LBLonfine-needleaspirationandeffusioncytologyspecimens,therebyobviatingtheneedforabiopsy.Cancer(CancerCytopathol);:-.?AmericanCancerSociety.









































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