Rao I S, Singh M K, Gupta S D, Pandhi R K, Kapila K
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Diagn Cytopathol. 2001 May;24(5):317-21. doi: 10.1002/dc.1068.
The role of fine-needle aspiration cytology (FNAC) in the diagnosis of benign skin lesions has been restricted primarily to the evaluation of bacteriologic and morphologic indices in leprosy. This study was undertaken to evaluate the efficacy of FNAC in the diagnosis and classification of lepromatous lesions. Aspirates of 94 newly diagnosed cases of leprosy were studied, and the bacterial load was determined by modified Ziehl-Neelsen (ZN) stain. A skin biopsy was taken from the same site at the same sitting. Frozen and paraffin sections stained with hematoxylin-eosin (H&E) and ZN stains were examined from the biopsy specimen. In 61 of 94 cases (64.9%), the aspirates were satisfactory. Both diagnosis and classification of leprosy were possible in 40 of these 61 cases; the rest of the aspirates showed nonspecific chronic inflammation. The 39 cases of leprosy where a biopsy was available from the same site were classified on FNAC into tuberculoid (TT and BT), lepromatous (LL and BL), and midborderline (BB) subtypes. Taking the histologic diagnosis and Ridley-Jopling classification to be the gold standard, a strong concordance in tuberculoid leprosy cases (18 of 20 cases, 90%) and in lepromatous cases (15 of 16 cases, 93.7%) was observed. Midborderline cases of leprosy posed a problem, and a correct cytohistological correlation was observed in only one of the three cases.
细针穿刺细胞学检查（FNAC）在良性皮肤病变诊断中的作用主要局限于对麻风病的细菌学和形态学指标评估。本研究旨在评估FNAC在瘤型麻风病变诊断和分类中的效能。对94例新诊断的麻风病病例的抽吸物进行了研究，并通过改良齐-尼（ZN）染色确定细菌载量。在同一时间从相同部位进行皮肤活检。对活检标本的冰冻切片和苏木精-伊红（H&E）及ZN染色的石蜡切片进行检查。94例中有61例（64.9%）的抽吸物是满意的。这61例中有40例既可以进行麻风病的诊断也可以进行分类；其余抽吸物显示非特异性慢性炎症。对可从相同部位获得活检的39例麻风病病例，通过FNAC分为结核样型（TT和BT）、瘤型（LL和BL）和中间界线类（BB）亚型。以组织学诊断和里德利-乔普林分类作为金标准，观察到结核样型麻风病例（20例中的18例，90%）和瘤型病例（16例中的15例，93.7%）有很强的一致性。麻风病的中间界线类病例存在问题，3例中只有1例观察到正确的细胞组织学相关性。
