Tsang W Y, Chan J K
Institute of Pathology, Queen Elizabeth Hospital, Hong Kong.
Hum Pathol. 1992 May;23(5):562-5. doi: 10.1016/0046-8177(92)90134-o.
Fine needle aspiration biopsy (FNAB) is a commonly used diagnostic tool for the investigation of lymphadenopathy, but little has been written about the morphologic changes resulting from this procedure and whether these changes interfere with subsequent histologic assessment. We therefore reviewed the histologic sections of a consecutive series of lymph node biopsies with previous FNAB. Ten out of 230 such cases showed changes attributable to FNAB. In four cases, hemorrhage accompanied by various stages of organization was seen, with a linear needle tract being identified in two of them. Proliferation of spindle cells around the hemorrhagic foci could raise a concern for Kaposi's sarcoma. Three cases showed segmental infarction of the nodal parenchyma, characterized by a wedge-shaped area of lymphocyte depletion and hemorrhage. Three cases showed total coagulative necrosis, which was attributable to the effects of FNAB rather than to spontaneous occurrence because the aspirates yielded abundant viable large atypical lymphoid cells. These three cases of total infarction were proven to be large-cell lymphoma upon subsequent biopsies. We conclude that the FNAB procedure may rarely affect histologic assessment of lymph nodes when there is florid myofibroblastic proliferation or total infarction. The latter complication is more likely to occur in lymph nodes involved by malignant lymphoma.
细针穿刺活检（FNAB）是用于检查淋巴结病的常用诊断工具，但关于该操作引起的形态学变化以及这些变化是否会干扰后续组织学评估的报道较少。因此，我们回顾了一系列先前接受过FNAB的连续淋巴结活检组织切片。在230例此类病例中，有10例显示出与FNAB相关的变化。4例可见伴有不同机化阶段的出血，其中2例可识别出线性针道。出血灶周围梭形细胞的增殖可能会引起对卡波西肉瘤的担忧。3例显示淋巴结实质节段性梗死，其特征为淋巴细胞缺失和出血的楔形区域。3例显示完全凝固性坏死，这归因于FNAB的影响而非自发发生，因为穿刺物产生了大量存活的大的非典型淋巴细胞。后续活检证实这3例完全梗死病例为大细胞淋巴瘤。我们得出结论，当存在活跃的肌成纤维细胞增殖或完全梗死时，FNAB操作可能很少影响淋巴结的组织学评估。后一种并发症更可能发生在恶性淋巴瘤累及的淋巴结中。
