Perske Christina, Nagel Ingelore, Nagel Holger, Strik Herwig
Department of Pathology, University of Göttingen, Göttingen, Germany.
Diagn Cytopathol. 2011 Aug;39(8):621-6. doi: 10.1002/dc.21510. Epub 2010 Nov 22.
To evaluate different morphological criteria for the distinction between inflammatory and neoplastic lymphocytes in the cerebrospinal fluid (CSF). Forty-two cytospin preparations of CSF from patients with confirmed CSF involvement by aggressive B-cell lymphoma or acute leukemia were compared with 26 samples of inflammatory diseases. CSF cytology was analyzed morphologically for preselected parameters of cell, cytoplasm and nucleic appearance, and the presence of mitoses or apoptoses. None of the evaluated parameters sharply discerns neoplastic and inflammatory changes. However, neoplastic cells were significantly larger. Moreover, irregular shape and pointed borders of the cytoplasm, and deep notches in the nucleus were significantly more frequent in neoplastic than in inflammatory lymphocytes. No single parameter is sufficient to detect neoplastic lymphocytes. Considering a combination of cell size and irregular shape of cell and nucleus, however, may improve the diagnostic accuracy of CSF dissemination by aggressive hematological malignancies.
评估用于区分脑脊液（CSF）中炎性淋巴细胞和肿瘤性淋巴细胞的不同形态学标准。将42例经确诊脑脊液受累的侵袭性B细胞淋巴瘤或急性白血病患者的脑脊液细胞涂片制剂与26例炎性疾病样本进行比较。对脑脊液细胞学进行形态学分析，观察细胞、细胞质和细胞核外观的预选参数，以及有丝分裂或凋亡的存在情况。所评估的参数均不能清晰地区分肿瘤性和炎性变化。然而，肿瘤细胞明显更大。此外，肿瘤性淋巴细胞的细胞质形状不规则、边界尖锐以及细胞核有深切迹的情况明显比炎性淋巴细胞更常见。没有单一参数足以检测肿瘤性淋巴细胞。然而，综合考虑细胞大小以及细胞和细胞核的不规则形状，可能会提高侵袭性血液系统恶性肿瘤脑脊液播散的诊断准确性。
