Li Jinnan, Zhao Sha, Zhang Wenyan, Jiang Yong, Zhu Xianglan, Den Xueqin, Liu Weiping, Su Xueying
Department of Pathology, West China Hospital of Sichuan University, Chengdu, China.
Front Med (Lausanne). 2020 Dec 3;7:615080. doi: 10.3389/fmed.2020.615080. eCollection 2020.
The aim of this study was to establish the liability of cytological diagnostic and, along with ancillary techniques, to sub-classify hematopoietic malignancies in serous effusions. We retrospectively reviewed the serous effusions of hematopoietic malignancies over an 11-year period, along with ancillary studies, clinical and histological data. We compared cytological along with histological diagnosis to evaluate the value of cytology itself. Furthermore, the discrepant cases were reviewed. In this study, a total of 242 cases were identified as hematopoietic malignancies. Ancillary technologies were performed: in 24 cases FCM, 242 cases ICC, 35 cases ISH, 81 cases PCR and 10 cases FISH. Cyto-histological correlation was available for 122 cases. The subtyping of hematopoietic malignancies was achieved using cytological material in 65/122 cases (53.3%). Of the 65 cases, T-Acute lymphoblastic leukemia/lymphoma (22.1%) was the leading subtype, followed by Burkitt lymphoma (5.7%), plasmacytoma (5.7%). Cyto-histological correlation showed a 100% concordant rate of diagnosis for hematopoietic malignancies and a high degree of agreement on sub-classification (51.6%). In this regard, T-acute lymphoblastic leukemia/lymphoma, plasmacytoma, extranodal NK/T-cell lymphoma, nasal type, anaplastic large cell lymphoma, myeloid sarcoma, and follicular lymphoma showed the highest degree of agreement (100%). The sub-classification on cytology was achieved in 53 out of the remaining 120 cases without histological diagnosis (44.2%). T-acute lymphoblastic leukemia/lymphoma (20.8%) was again the most frequently encountered subtype, followed by plasmacytoma (5.8%) and Burkitt lymphoma (4.2%). This large series study provided evidence that combining cytology and ancillary studies enabled the accurate serous effusions cytological diagnoses and subsequent sub-classification for the described malignancies.
本研究的目的是确定细胞学诊断的可靠性,并结合辅助技术对浆膜腔积液中的造血系统恶性肿瘤进行亚分类。我们回顾性分析了11年间造血系统恶性肿瘤的浆膜腔积液,并结合辅助检查、临床和组织学数据。我们比较了细胞学诊断和组织学诊断,以评估细胞学本身的价值。此外,对存在差异的病例进行了复查。在本研究中,共有242例被确诊为造血系统恶性肿瘤。采用了辅助技术:24例进行了流式细胞术(FCM),242例进行了免疫细胞化学(ICC),35例进行了原位杂交(ISH),81例进行了聚合酶链反应(PCR),10例进行了荧光原位杂交(FISH)。122例病例有细胞-组织学相关性分析。65/122例(53.3%)利用细胞学材料实现了造血系统恶性肿瘤的亚分类。在这65例中,T急性淋巴细胞白血病/淋巴瘤(22.1%)是主要亚型,其次是伯基特淋巴瘤(5.7%)、浆细胞瘤(5.7%)。细胞-组织学相关性分析显示,造血系统恶性肿瘤的诊断符合率为100%,亚分类的一致性程度较高(51.6%)。在这方面,T急性淋巴细胞白血病/淋巴瘤、浆细胞瘤、结外NK/T细胞淋巴瘤、鼻型、间变性大细胞淋巴瘤、髓系肉瘤和滤泡性淋巴瘤的一致性程度最高(100%)。在其余120例无组织学诊断的病例中,53例(44.2%)通过细胞学实现了亚分类。T急性淋巴细胞白血病/淋巴瘤(20.8%)再次成为最常见的亚型,其次是浆细胞瘤(5.8%)和伯基特淋巴瘤(4.2%)。这项大型系列研究提供了证据,表明结合细胞学和辅助检查能够对所述恶性肿瘤进行准确的浆膜腔积液细胞学诊断及后续亚分类。