Cho Eun Yoon, Gong Gyungyub, Khang Shin Kwang, Kang Yoon-Koo, Huh Jooryung
Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan-College of Medicine, Seoul, Korea.
Cancer. 2002 Dec 25;96(6):344-50. doi: 10.1002/cncr.10885.
Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare form of lymphoma with a predilection for Southeast Asians, including Koreans, and Central and South Americans. It has a high association with Epstein-Barr virus (EBV) and expression of CD56 antigen. In the current study, the authors reviewed the fine needle aspiration (FNA) cytology of NK/T-cell lymphoma involving soft tissue to identify characteristic cytologic features.
Ten FNAs of soft tissue involvement by histologically documented NK/T-cell lymphoma from eight patients (three nasal primary and five extranasal primary tumors) were included in the retrospective study of a six-year period (1996-2002). Diff-Quik- and Papanicolaou-stained smears were reviewed, as was the biopsy material, including immunohistochemical stains and in situ hybridization studies for EBV. Clinical information was obtained from the patients' medical records.
Specimen sources were skin and subcutaneous tissue of the neck (3), arm (3), breast (2), and abdominal wall (1) and soft tissue of the buccal area (1). The smears were moderately to highly cellular in the extensively necrotic background, with an abundance of apoptotic debris. Single, scattered tumor cells had pleomorphic nuclei, coarse chromatin, indistinct or several small nucleoli, and eccentric bluish cytoplasm. Neutrophils were typically rare in most cases except in one case complicated by abscess.
Fine needle aspiration can be a useful adjunct in the diagnosis of the nasal and extranasal NK/T-cell lymphoma. The presence of malignant lymphoid cells in a necrotic background with an abundance of apoptotic bodies is a highly characteristic and consistent finding in FNA of NK/T-cell lymphoma involving soft tissue.
结外自然杀伤（NK）/T细胞淋巴瘤，鼻型，是一种罕见的淋巴瘤形式，好发于东南亚人，包括韩国人，以及中南美洲人。它与爱泼斯坦-巴尔病毒（EBV）及CD56抗原的表达高度相关。在本研究中，作者回顾了累及软组织的NK/T细胞淋巴瘤的细针穿刺（FNA）细胞学检查，以确定其特征性的细胞学特征。
对8例患者（3例鼻腔原发性和5例鼻腔外原发性肿瘤）经组织学证实的累及软组织的NK/T细胞淋巴瘤的10次FNA进行了为期6年（1996 - 2002年）的回顾性研究。对Diff-Quik和巴氏染色涂片进行了复查，活检材料也进行了复查，包括EBV的免疫组化染色和原位杂交研究。从患者的病历中获取临床信息。
标本来源为颈部皮肤和皮下组织（3例）、手臂（3例）、乳腺（2例）、腹壁（1例）以及颊部软组织（1例）。涂片在广泛坏死背景下细胞丰富程度为中度至高度，伴有大量凋亡碎片。单个散在的肿瘤细胞具有多形性核、粗糙的染色质、不明显或多个小核仁以及偏心的蓝色细胞质。除1例合并脓肿的病例外，大多数病例中性粒细胞通常少见。
细针穿刺可作为鼻腔和鼻腔外NK/T细胞淋巴瘤诊断的有用辅助手段。在累及软组织的NK/T细胞淋巴瘤的FNA中，坏死背景下存在恶性淋巴细胞并伴有大量凋亡小体是一个高度特征性且一致的发现。
