Funamoto Yasunobu, Nagai Masami, Haba Reiji, Ishikawa Masashi, Kishida Fujio, Kohno Kohoji, Matsunaga Toru, Kushida Yoshio, Kobayashi Shoji
Department of Diagnostic Pathology, Kagawa University Hospital, Kita-Gun, Kagawa, Japan.
Diagn Cytopathol. 2005 Jul;33(1):20-5. doi: 10.1002/dc.20254.
Our objective was to evaluate the usefulness of cytomorphologic assessment in the accuracy of diagnosis of Hodgkin's disease (HD), using imprint cytological preparations over a 18-yr period. Imprint materials from 34 HD cases were reviewed using cytomorphological and immunocytochemical studies. Twenty-six cases (76.5%) were diagnosed to be HD and 6 cases (17.6%) were suspected to be HD, but 2 cases (5.9%) were cytologically diagnosed as reactive lesions, because of an insufficient number of Reed-Sternberg (RS) cells. The 6 suspected cases were definitively diagnosed as HD, using immunocytochemistry. Immunophenotyping of RS cells in 32 cases (excluding the two cases of reactive lesions) showed CD30+ in 31 (96.9%) cases, CD15+ in 22 (68.8%) cases and CD20+ in 12 (37.5%) cases. RS cells were immunophenotypically classified into five groups: A, (CD 30+, 15+, 20-) 15 (46.9%); B, (CD30+, 15-, 20-) 5 (15.6%); C, (CD 30+, 15+, 20+) 6 (18.8%); D, (CD30+, 15-, 20+) 5 (15.6%); and E, (CD30-, 15+, 20+) 1 (3.1%). Cytomorphologic differences in RS cells were identified between group D and other groups (CD15+ and/ or CD20-). The former had a low polymorphic shape (like popcorn), and the latter had a more classical polymorphic shape. Epstein-Barr virus (EBV)-latent membrane protein-1(LMP-1) was identified in 16 (50%) cases. LMP-1 expression was found not only in classic RS cells, but also in smaller variants. These variants did not match the morphologic criteria of RS cells, but expressed the common phenotype (CD30+, CD15+/-) of RS cells, suggesting the same cellular origin as RS cells. This study demonstrated that imprint cytology from lymph node biopsies can be a useful tool for the diagnosis and the evaluation of the cellular biology of HD.
我们的目的是通过对18年间的印片细胞学标本进行研究，评估细胞形态学评估在霍奇金淋巴瘤（HD）诊断准确性中的作用。我们使用细胞形态学和免疫细胞化学研究方法，对34例HD病例的印片材料进行了回顾性分析。26例（76.5%）被诊断为HD，6例（17.6%）疑似HD，但2例（5.9%）因里德-斯腾伯格（RS）细胞数量不足，细胞学诊断为反应性病变。6例疑似病例经免疫细胞化学确诊为HD。32例（不包括2例反应性病变）RS细胞的免疫表型分析显示，31例（96.9%）CD30阳性，22例（68.8%）CD15阳性，12例（37.5%）CD20阳性。RS细胞的免疫表型分为五组：A组（CD30阳性、CD15阳性、CD20阴性）占15例（46.9%）；B组（CD30阳性、CD15阴性、CD20阴性）占5例（15.6%）；C组（CD30阳性、CD15阳性、CD20阳性）占6例（18.8%）；D组（CD30阳性、CD15阴性、CD20阳性）占5例（15.6%）；E组（CD30阴性、CD15阳性、CD20阳性）占1例（3.1%）。D组与其他组（CD15阳性和/或CD20阴性）的RS细胞在细胞形态学上存在差异。前者呈低多形性形态（如爆米花状），后者呈更典型的多形性形态。16例（50%）检测到爱泼斯坦-巴尔病毒（EBV）潜伏膜蛋白1（LMP-1）。LMP-1不仅在经典RS细胞中表达，在较小的变异细胞中也有表达。这些变异细胞不符合RS细胞的形态学标准，但表达RS细胞的共同表型（CD30阳性、CD15阳性/阴性），提示与RS细胞有相同的细胞起源。本研究表明，淋巴结活检的印片细胞学检查可作为HD诊断及细胞生物学评估的有用工具。
