Barroca Helena, Marques Cristina
Laboratório de Anatomia Patológica, Centro Hospitalar de S. João, Porto, Portugal.
Acta Cytol. 2016;60(4):284-301. doi: 10.1159/000448679. Epub 2016 Sep 17.
According to the World Health Organization (WHO), the new classification of lymphomas is mainly based on morphological, immunophenotypical, and molecular criteria. Consequently, this new approach has led from the substantial role that architecture played in the past to a secondary panel highlighting the role of fine-needle biopsy (FNB). Applied together with other ancillary techniques, such as flow cytometry (FC), FNB is a potential tool for the diagnosis of lymphomas, and enlarged lymph nodes represent an excellent target for the implementation of this technique. Despite the difficulties inherent in this technology, which might pose problems in differential diagnosis, in the majority of cases this joint work allows an accurate diagnosis of malignancy and even correct subcharacterization in routine lymphomas. Additionally, in selected cases, other molecular techniques like FISH and PCR can also be performed on FNB specimens, helping in the characterization and diagnosis of lymphomas. In this review, we discuss the basic aspects of the combination of FNB cytology and FC in the diagnosis and subclassification of lymphomas. The preanalytical phase is extensively discussed. The advantages, disadvantages, and technical limitations of this joint work are addressed in general and in terms of the accurate subclassification of lymphomas.
根据世界卫生组织（WHO）的说法，淋巴瘤的新分类主要基于形态学、免疫表型和分子标准。因此，这种新方法已从过去架构所起的重要作用转变为突出细针穿刺活检（FNB）作用的次要方面。与其他辅助技术（如流式细胞术（FC））一起应用时，FNB是诊断淋巴瘤的一种潜在工具，肿大的淋巴结是实施该技术的理想目标。尽管这项技术存在固有的困难，可能在鉴别诊断中带来问题，但在大多数情况下，这种联合应用能够在常规淋巴瘤中准确诊断恶性肿瘤甚至进行正确的亚型分类。此外，在特定病例中，还可以对FNB标本进行其他分子技术检测，如荧光原位杂交（FISH）和聚合酶链反应（PCR），有助于淋巴瘤的特征描述和诊断。在本综述中，我们讨论了FNB细胞学与FC联合应用于淋巴瘤诊断和亚型分类的基本方面。对分析前阶段进行了广泛讨论。总体上以及就淋巴瘤的准确亚型分类而言，探讨了这种联合应用的优点（优势）、缺点（劣势）和技术局限性。
