Department of Veterinary Medicine, University of Milan, Lodi, Italy.
Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, Milan, Italy.
J Vet Intern Med. 2022 Jan;36(1):204-214. doi: 10.1111/jvim.16326. Epub 2021 Nov 27.
Cytopathology is a minimally invasive and convenient diagnostic procedure, often used as a substitute for histopathology to diagnose and characterize lymphoma in dogs.
Assess the diagnostic performance of cytopathology in diagnosing lymphoma and its histopathological subtypes in dogs.
One-hundred and sixty-one lymph node samples from 139 dogs with enlarged peripheral lymph nodes.
Based only on cytopathology, 6 examiners independently provided the following interpretations on each sample: (a) lymphoma vs nonlymphoma; (b) grade and phenotype; and (c) World Health Organization (WHO) histopathological subtype. Histopathology and immunohistochemistry (IHC) findings were used as reference standards to evaluate diagnostic performance of cytopathology. Clinical, clinicopathologic, and imaging data also were considered in the definitive diagnosis.
Classification accuracy for lymphoma consistently was >80% for all examiners, whereas it was >60% for low grade T-cell lymphomas, >30% for high grade B-cell lymphomas, >20% for high grade T-cell lymphomas, and <40% for low grade B-cell lymphomas. Interobserver agreement evaluated by kappa scores was 0.55 and 0.32 for identification of lymphoma cases, and of grade plus immunophenotype, respectively.
Cytopathology may result in accurate diagnosis of lymphoma, but accuracy decreases when further characterization is needed. Cytopathology represents a fundamental aid in identifying lymphoma and can be used as a screening test to predict grade and phenotype. However, these results must be confirmed using other ancillary techniques, including flow cytometry, histopathology, and immunohistochemistry (IHC).
细胞学是一种微创且便捷的诊断程序，常被用作组织病理学的替代方法，用于诊断和确定犬淋巴瘤的特征。
评估细胞学在诊断犬淋巴瘤及其组织病理学亚型方面的诊断性能。
139 只外周淋巴结肿大的犬的 161 个淋巴结样本。
仅基于细胞学，6 位检查者独立对每个样本进行以下解读：（a）淋巴瘤与非淋巴瘤；（b）分级和表型；（c）世界卫生组织（WHO）组织病理学亚型。将组织病理学和免疫组织化学（IHC）结果用作参考标准来评估细胞学的诊断性能。在明确诊断中还考虑了临床、临床病理和影像学数据。
对于所有检查者，淋巴瘤的分类准确率始终>80%，而低级别 T 细胞淋巴瘤的准确率>60%，高级别 B 细胞淋巴瘤的准确率>30%，高级别 T 细胞淋巴瘤的准确率>20%，而低级别 B 细胞淋巴瘤的准确率<40%。通过 Kappa 评分评估的观察者间一致性分别为 0.55 和 0.32，用于识别淋巴瘤病例和分级加免疫表型。
细胞学可能导致对淋巴瘤的准确诊断，但当需要进一步特征描述时，准确性会降低。细胞学是识别淋巴瘤的基本辅助手段，可用于预测分级和表型的筛查试验。然而，这些结果必须使用其他辅助技术（包括流式细胞术、组织病理学和免疫组织化学（IHC））来确认。
