细针抽吸、细胞块和免疫组织化学技术诊断原发性甲状腺淋巴瘤。
The diagnosis of primary thyroid lymphoma by fine-needle aspiration, cell block, and immunohistochemistry technique.
机构信息
Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Orthopaedics, Luzhou Traditional Chinese Medicine Hospital, Luzhou, China.
出版信息
Diagn Cytopathol. 2020 Nov;48(11):1041-1047. doi: 10.1002/dc.24526. Epub 2020 Jul 1.
AIM
Primary thyroid lymphoma (PTL) is a rare malignant disease. Its prognosis depends on early diagnosis. The role of fine-needle aspiration (FNA), including smear cytology, cell block (CB) techniques, and immunohistochemistry (IHC) sections in the diagnosis of PTL is still unclear. Here we reported 19 cases of PTL and literature review to evaluate the diagnostic accuracy for lymphoma by cytology.
METHODS
Our study retrospectively reviewed 19 patients diagnosed with PTL at the affiliated hospital of Southwest Medical University in China from June 2011 to May 2019. According to the Bethesda system for reporting thyroid cytopathology, the CB sections were evaluated for the presence of single tumor cells. IHC was performed on CB.
RESULTS
The diagnostic accuracy for PTL of FNA, CB with smears, and the joint application of the three methods (FNA + CB + IHC) of our study with 19 cases was 68.4% (13/19), 83.3% (15/18), and 100% (17/17), respectively.
CONCLUSION
The present study demonstrates that FNA has low sensitivity in diagnosing PTL, but the joint application of FNA, CB, and IHC might provide high diagnostic accuracy for lymphoma and should be applied in all cases where the clinical suspicion is high regardless of the FNA findings.
目的
原发性甲状腺淋巴瘤（PTL）是一种罕见的恶性疾病。其预后取决于早期诊断。细针穿刺（FNA），包括涂片细胞学、细胞块（CB）技术和免疫组织化学（IHC）切片在 PTL 诊断中的作用仍不清楚。在此，我们报告了 19 例 PTL 病例，并进行文献复习，以评估细胞学对淋巴瘤的诊断准确性。
方法
我们的研究回顾性分析了 2011 年 6 月至 2019 年 5 月在中国西南医科大学附属医院诊断为 PTL 的 19 例患者。根据甲状腺细胞病理学报告的 Bethesda 系统，评估 CB 切片中是否存在单个肿瘤细胞。对 CB 进行 IHC 检测。
结果
FNA、涂片 CB 和 FNA+CB+IHC 三种方法诊断 PTL 的准确性分别为 68.4%（13/19）、83.3%（15/18）和 100%（17/17）。
结论
本研究表明 FNA 诊断 PTL 的敏感性较低，但 FNA、CB 和 IHC 的联合应用可能为淋巴瘤提供较高的诊断准确性，并且应该应用于所有临床怀疑较高的病例，而不考虑 FNA 结果。
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