Zeppa Pio, Picardi Marco, Marino Gilda, Troncone Giancarlo, Fulciniti Franco, Vetrani Antonio, Rotoli Bruno, Palombini Lucio
Dipartimento di Anatomia Patologica e Citopatologia, Facoltà di Medicina e Chirurgia, Università di Napoli "Federico II," Napoli, Italy.
Cancer. 2003 Apr 25;99(2):118-27. doi: 10.1002/cncr.11011.
Flow cytometry (FC) is a useful adjunct to fine-needle aspiration biopsy (FNAB) in the evaluation of lymphoproliferative disorders. The application of FC to FNAB of the spleen (sFNAB) is reported.
Flow cytometry was performed on 18 sFNAB collected over 3 years. The series comprised 10 cases of non- Hodgkin lymphomas (NHL), 2 cases insufficient for diagnosis, 2 cases of reactive hyperplasia (RH), and 4 cases of myeloid metaplasia (MM). FNAB was performed under ultrasound guidance using a 22-gauge needle. One or two passes were sufficient to prepare a conventional smear that was immediately evaluated to select the cases studied and to prepare a cell suspension for FC. The following fluoresceinated antibodies were used: CD3, CD19/kappa/lambda, FMC7/CD23/CD19, Bcl-2, and CD13/HLA-DR. In six cases, cytospins were also prepared for immunocytochemistry and were tested for CD20 (L26), CD45Ro, and kappa and lambda light chain expression.
Flow cytometry contributed to the diagnosis of all cases of NHL by assessing light chain restriction. The specific subtype was also diagnosed by CD19/CD5 and CD 19/CD10 coexpression in two cases. Flow cytometry quantified the percentage of myeloid cells in MM cases and contributed to the cytologic diagnosis showing a polyclonal light chain expression in RH cases. Immunocytochemistry was effective and concordant in four cases. Patients tolerated the sFNAB well and no complications were reported. Cytologic and FC diagnoses were confirmed by follow-up and by histologic evaluation in cases in which splenectomy was performed for therapeutic purposes.
Flow cytometry applied to sFNAB corroborates the cytologic diagnosis in lymphoid and myeloproliferative disorders of the spleen and allows therapeutic decisions avoiding splenectomy.
流式细胞术（FC）是细针穿刺活检（FNAB）评估淋巴增殖性疾病的有用辅助手段。本文报道了FC在脾脏细针穿刺活检（sFNAB）中的应用。
对3年中收集的18例sFNAB进行流式细胞术检测。该系列包括10例非霍奇金淋巴瘤（NHL）、2例诊断不足病例、2例反应性增生（RH）和4例骨髓化生（MM）。在超声引导下使用22号针进行FNAB。穿刺一两次就足以制备常规涂片，立即对其进行评估以选择研究病例并制备用于FC的细胞悬液。使用了以下荧光标记抗体：CD3、CD19/κ/λ、FMC7/CD23/CD19、Bcl-2和CD13/HLA-DR。在6例病例中，还制备了细胞涂片用于免疫细胞化学检测，并检测了CD20（L26）、CD45Ro以及κ和λ轻链表达。
流式细胞术通过评估轻链限制有助于所有NHL病例的诊断。在2例病例中，还通过CD19/CD5和CD19/CD10共表达诊断出特定亚型。流式细胞术对MM病例中的髓样细胞百分比进行了定量，并有助于细胞学诊断，显示RH病例中为多克隆轻链表达。免疫细胞化学在4例病例中有效且结果一致。患者对sFNAB耐受性良好，未报告并发症。对于因治疗目的而进行脾切除术的病例，通过随访和组织学评估证实了细胞学和FC诊断。
应用于sFNAB的流式细胞术可证实脾脏淋巴和骨髓增殖性疾病的细胞学诊断，并有助于做出避免脾切除术的治疗决策。
