Kardos T F, Kornstein M J, Frable W J
Department of Pathology, Medical College of Virginia, Richmond.
Acta Cytol. 1988 Sep-Oct;32(5):722-6.
Two cases of infectious mononucleosis with atypical clinical presentations were initially diagnosed by fine needle aspiration (FNA) of lymph nodes and subsequently confirmed by serologic studies. The cytologic features that allowed recognition included a high percentage of cells with relatively abundant cytoplasm that stained pale to deep blue using a Giemsa-type stain. Many of the cells had plasmacytoid features. The cells ranged in size from small lymphocytes to large immunoblastic forms. Other features included mitotic figures and occasional binucleated forms. Immunologic studies showed a mixture of B and T cells, with many of the cells having a cytotoxic/suppressor phenotype. The features seem to be relatively characteristic and distinct from those of malignant processes that could be aspirated in lymph nodes. Recognition of infectious mononucleosis by FNA in these cases allowed for confirmation by serologic studies, thereby avoiding the need for an excisional biopsy. These cases show that FNA of lymph nodes may shed light on the nature of the process underlying the lymphadenopathy in selected cases of clinically atypical infectious mononucleosis.
两例具有非典型临床表现的传染性单核细胞增多症最初通过淋巴结细针穿刺活检（FNA）诊断，随后经血清学研究确诊。可识别的细胞学特征包括：使用吉姆萨染色法时，有较高比例的细胞胞质相对丰富，染成淡蓝色至深蓝色。许多细胞具有浆细胞样特征。细胞大小从小淋巴细胞到大型免疫母细胞不等。其他特征包括有丝分裂象和偶尔的双核形式。免疫学研究显示B细胞和T细胞混合存在，许多细胞具有细胞毒性/抑制性表型。这些特征似乎相对具有特异性，与可通过淋巴结穿刺吸出的恶性病变特征不同。在这些病例中，通过FNA识别传染性单核细胞增多症后，经血清学研究得以确诊，从而避免了进行切除活检的必要性。这些病例表明，在某些临床非典型传染性单核细胞增多症病例中，淋巴结FNA可能有助于揭示淋巴结病潜在病变的性质。
