Department of Pathology, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 71130, USA.
Cancer Cytopathol. 2010 Apr 25;118(2):105-12. doi: 10.1002/cncy.20070.
Fine-needle aspiration (FNA) has been used in the evaluation of lymphadenopathy for a long time and is highly reliable in the identification of metastatic malignancies. However, the role of FNA in the assessment of new lymphoproliferative disorders continues to be a subject of debate. The objective of the current study was to evaluate the role of molecular cytogenetic studies in FNA diagnoses of lymphoproliferative disorders.
A retrospective, computer-based search for lymph node FNAs from 2006 to 2007 was performed. Cases with either fluorescence in situ hybridization (FISH) and/or polymerase chain reaction (PCR) studies were subjected to further analysis.
In total, 243 lymph node FNAs were performed during the period, including 104 that were positive/suspicious for metastatic malignancies, 16 that were positive/suspicious for lymphomas, 15 that demonstrated atypical lymphoid proliferation, 73 that were reactive, 14 that were deemed granulomas, and 21 that were determined to be nondiagnostic. Molecular analysis included combined FISH/PCR in 4 cases, FISH only in 7 cases, and PCR only in 4 cases. By using multiplex PCR, 6 cases with atypical/negative flow cytometry results were diagnosed as 4 B-cell lymphomas, 1 T-cell lymphoma, and 1 reactive lymph node; and 4 cases that had atypical T cells determined by flow cytometry were diagnosed as reactive. One CD10-negative follicular lymphoma and 2 cases with suspicious flow cytometry results were positive for t(14;18)(q32;q21) by FISH. Forty-five cases had follow-up histology with 3 false-negative findings and no false-positive results.
In this study, multiplex PCR studies for immunoglobulin heavy-chain or T-cell receptor gene rearrangements were useful for demonstrating clonality, and FISH studies were able to detect translocations or gene rearrangements that allowed for the subclassification of B-cell non-Hodgkin lymphomas.
细针穿刺（FNA）在评估淋巴结疾病方面已经应用了很长时间，在识别转移性恶性肿瘤方面具有高度可靠性。然而，FNA 在评估新的淋巴增生性疾病中的作用仍然是一个有争议的话题。本研究的目的是评估分子细胞遗传学研究在 FNA 诊断淋巴增生性疾病中的作用。
对 2006 年至 2007 年的淋巴结 FNA 进行了回顾性、基于计算机的检索。对进行荧光原位杂交（FISH）和/或聚合酶链反应（PCR）研究的病例进行了进一步分析。
在此期间共进行了 243 例淋巴结 FNA，其中 104 例为转移性恶性肿瘤阳性/可疑，16 例为淋巴瘤阳性/可疑，15 例为不典型淋巴样增生，73 例为反应性，14 例为肉芽肿，21 例为非诊断性。分子分析包括 4 例联合 FISH/PCR、7 例 FISH 仅和 4 例 PCR 仅。通过使用多重 PCR，6 例流式细胞术结果不典型/阴性的病例被诊断为 4 例 B 细胞淋巴瘤、1 例 T 细胞淋巴瘤和 1 例反应性淋巴结；4 例流式细胞术显示不典型 T 细胞的病例被诊断为反应性。1 例 CD10 阴性滤泡性淋巴瘤和 2 例流式细胞术可疑结果的病例 FISH 检测到 t(14;18)(q32;q21)阳性。45 例有随访组织学，有 3 例假阴性，无假阳性。
在本研究中，免疫球蛋白重链或 T 细胞受体基因重排的多重 PCR 研究有助于证明克隆性，FISH 研究能够检测到易位或基因重排，从而对 B 细胞非霍奇金淋巴瘤进行亚分类。
