Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cancer Cytopathol. 2017 Feb;125(2):104-113. doi: 10.1002/cncy.21799. Epub 2016 Nov 21.
Grade 2 nodular sclerosis classical Hodgkin lymphoma (NSCHL) is less common than grade 1 lymphoma and has a worse overall prognosis. To the best of the authors' knowledge, no study of a large series of cases has been performed until now. The objective of this study was to assess the diagnostic efficacy of cytology for grade 2 NSCHL versus grade 1 NSCHL and study the morphological features of grade 2 NSCHL in fine-needle aspiration cytology (FNAC).
Fifteen of 51 histopathology-proven cases of NSCHL (18 FNAC procedures) were grade 2, and 36 were grade 1. The efficacy of FNAC for detecting grade 1 and 2 NSCHL was assessed, and the frequency of misdiagnosis was compared. The clinical details and cytomorphological features of grade 2 NSCHL were studied in detail.
Among the grade 1 NSCHL patients, 58.4% were diagnosed with Hodgkin lymphoma (HL) or had findings suggestive of HL, whereas 20% of the grade 2 patients were diagnosed HL or suggestive of HL. Two cases of grade 2 NSCHL were misdiagnosed as anaplastic large cell lymphoma, and 4 were misdiagnosed as malignant neoplasms. Grade 2 NSCHL cases showed clusters and sheets of mononuclear, multinucleated, and bizarre cells, with some cases showing a suppurative background. However, extensive searching showed occasional Reed-Sternberg (RS) cells in most of the cases, and lacunar cells were seen in 12 cases.
The diagnostic efficacy of FNAC is much lower for grade 2 NSCHL versus grade 1 NSCHL. The search for an occasional RS cell and the identification of lacunar cells can provide a clue for the diagnosis. Cancer Cytopathol 2017;125:104-113. © 2016 American Cancer Society.
2 级结节硬化型经典霍奇金淋巴瘤（NSCHL）比 1 级淋巴瘤少见，总体预后较差。据作者所知，目前还没有对大量病例进行的研究。本研究的目的是评估细胞学对 2 级 NSCHL 与 1 级 NSCHL 的诊断效能，并研究细针抽吸细胞学（FNAC）中 2 级 NSCHL 的形态特征。
51 例经组织病理学证实的 NSCHL 中有 15 例（18 例 FNAC 检查）为 2 级，36 例为 1 级。评估 FNAC 检测 1 级和 2 级 NSCHL 的效能，并比较误诊率。详细研究了 2 级 NSCHL 的临床细节和细胞形态特征。
在 1 级 NSCHL 患者中，58.4%被诊断为霍奇金淋巴瘤（HL）或有 HL 表现，而 20%的 2 级患者被诊断为 HL 或有 HL 表现。2 例 2 级 NSCHL 误诊为间变大细胞淋巴瘤，4 例误诊为恶性肿瘤。2 级 NSCHL 病例显示单核、多核和奇异细胞的簇状和片状，部分病例呈化脓性背景。然而，在大多数病例中广泛搜索仅偶尔可见 Reed-Sternberg（RS）细胞，12 例可见腔隙细胞。
FNAC 对 2 级 NSCHL 的诊断效能明显低于 1 级 NSCHL。偶尔寻找 RS 细胞和识别腔隙细胞可为诊断提供线索。癌症细胞病理学 2017；125:104-113. © 2016 美国癌症协会。
