Koo C H, Rappaport H, Sheibani K, Pangalis G A, Nathwani B N, Winberg C D
James Irvine Center, Division of Pathology, City of Hope National Medical Center, Duarte, CA 91010.
Hum Pathol. 1989 Dec;20(12 Suppl 1):1-137. doi: 10.1016/0046-8177(89)90287-6.
The classification of non-Hodgkin's lymphomas (NHLs) has been traditionally based on analysis of histologic sections and has been supplemented more recently by immunologic marker studies. It was the purpose of the present study to illustrate, side-by-side, sections and Romanowsky-stained imprints from the same surgical specimen from practically all categories of immunophenotyped NHLs, including rare and atypical variants that were difficult to classify from the histologic sections alone. Our results indicate that imprint cytology may reveal nuclear and cytoplasmic details not discernible in even the best tissue sections and that it may be selectively helpful in contributing to the classification of NHLs. Our results also show that the relative value of imprint cytology in the classification of malignant lymphomas varies greatly among categories. Specifically, we have found that imprints assist in three ways: the recognition of plasmacytoid features in small cell lymphocytic lymphomas, the recognition of plasmacytoid immunoblastic lymphoma, and the differentiation between NHLs which may be difficult to distinguish histologically. These include (1) small lymphocytic lymphoma versus lymphocytic lymphoma of intermediate differentiation, (2) true histiocytic malignancies versus large cell malignant lymphomas with abundant cytoplasm and/or phagocytosis, (3) anaplastic myeloma versus plasmacytoid immunoblastic lymphoma, (4) large noncleaved versus plasmacytoid immunoblastic lymphoma, (5) lymphoblastic lymphoma versus diffuse small cleaved cell lymphoma, and (6) lymphoblastic lymphoma versus small noncleaved cell lymphoma. Lymph node imprints are easy to prepare and readily interpretable by those experienced in the study of abnormal blood and bone marrow films. Their value as an ancillary methodology aimed at optimal accuracy in the classification of NHLs should be recognized.
非霍奇金淋巴瘤（NHLs）的分类传统上基于组织学切片分析，最近又增加了免疫标志物研究作为补充。本研究的目的是将几乎所有免疫表型NHLs的同一手术标本的切片与罗曼诺夫斯基染色涂片并列展示，包括仅通过组织学切片难以分类的罕见和非典型变体。我们的结果表明，印片细胞学可能揭示即使在最佳组织切片中也无法辨别的细胞核和细胞质细节，并且在有助于NHLs的分类方面可能具有选择性帮助。我们的结果还表明，印片细胞学在恶性淋巴瘤分类中的相对价值在不同类别之间差异很大。具体而言，我们发现涂片在三个方面有帮助：识别小细胞淋巴细胞淋巴瘤中的浆细胞样特征、识别浆细胞样免疫母细胞淋巴瘤以及区分组织学上可能难以区分的NHLs。这些包括（1）小淋巴细胞淋巴瘤与中间分化的淋巴细胞淋巴瘤，（2）真性组织细胞恶性肿瘤与具有丰富细胞质和/或吞噬作用的大细胞恶性淋巴瘤，（3）间变性骨髓瘤与浆细胞样免疫母细胞淋巴瘤，（4）大无裂细胞淋巴瘤与浆细胞样免疫母细胞淋巴瘤，（5）淋巴母细胞淋巴瘤与弥漫性小裂细胞淋巴瘤，以及（6）淋巴母细胞淋巴瘤与小无裂细胞淋巴瘤。淋巴结印片易于制备，并且对于有异常血液和骨髓涂片研究经验的人来说很容易解释。应认识到它们作为一种辅助方法在NHLs分类中实现最佳准确性的价值。
