Department of Diagnostic Pathology and Cytology, Kuma Hospital, Hyogo 650-0011, Japan.
Department of Surgery, Kuma Hospital, Hyogo 650-0011, Japan.
Endocr J. 2022 Mar 28;69(3):291-297. doi: 10.1507/endocrj.EJ21-0451. Epub 2021 Oct 21.
Preoperative flow cytometry is recommended to prove the monoclonality and confirm the diagnosis of thyroid lymphoma. However, lymphoma cases without light chain restriction may also have monoclonality. The aim of our study was to identify a novel marker for thyroid lymphomas using aspirated materials for flow cytometry. We retrospectively analyzed 26 patients with primary thyroid lymphomas and 16 patients with benign lymphoproliferative lesions. The materials for flow cytometry were obtained by fine-needle aspiration cytology using a 22-gauge needle under ultrasound guidance. Light chain restriction was defined as a κ to λ ratio of less than 0.5 or more than 3.0. According to the light chain-positive rate, 25% or less and more than 25% were classified as the low and high light chain-positive rate groups, respectively. B-cell predominance was defined as a CD19 to CD4 ratio (B- to T-cell ratio) of more than 2.0. B-cell predominance was more frequently observed in lymphomas (88.5%) than in benign lymphoproliferative lesions (25.0%; p < 0.001). Light chain restriction based on the κ/λ ratio was detected in 69.2% of lymphomas, but not in benign lymphoproliferative lesions. Among lymphomas belonging to the low light chain-positive rate group, 88.9% did not exhibit light chain restriction and B-cell predominance was present. In contrast, benign lymphoproliferative lesions with B-cell predominance were not detected in the low light chain-positive rate group. B-cell predominance was a useful indicator for diagnosing thyroid lymphoma in the low light chain-positive rate group without light chain restriction.
术前流式细胞术被推荐用于证明单克隆性并确认甲状腺淋巴瘤的诊断。然而，没有轻链限制的淋巴瘤病例也可能具有单克隆性。我们的研究目的是使用流式细胞术的抽吸材料来鉴定甲状腺淋巴瘤的新型标志物。我们回顾性分析了 26 例原发性甲状腺淋巴瘤患者和 16 例良性淋巴增生性病变患者。流式细胞术的材料是在超声引导下使用 22 号针通过细针抽吸细胞学获得的。轻链限制定义为κ到λ的比值小于 0.5 或大于 3.0。根据轻链阳性率，将 25%或更低和 25%以上分别归类为低和高轻链阳性率组。B 细胞优势定义为 CD19 对 CD4 的比值（B 细胞与 T 细胞的比值）大于 2.0。B 细胞优势在淋巴瘤（88.5%）中比良性淋巴增生性病变（25.0%）更常见（p<0.001）。基于κ/λ 比值的轻链限制在 69.2%的淋巴瘤中检测到，但在良性淋巴增生性病变中未检测到。在属于低轻链阳性率组的淋巴瘤中，88.9%未显示轻链限制，并且存在 B 细胞优势。相比之下，在低轻链阳性率组中未检测到具有 B 细胞优势的良性淋巴增生性病变。在没有轻链限制的低轻链阳性率组中，B 细胞优势是诊断甲状腺淋巴瘤的有用指标。
