Schwarze E W
Veroff Pathol. 1986;123:1-241.
Imprints of lymph nodes and tumor specimens from 442 patients with non-Hodgkin's lymphoma (NHL) were evaluated cytologically and cytochemically. With the exception of hairy cell leukemia, special forms of peripheral pleomorphic T-cell lymphoma, and lymph node plasmacytoma, all types of NHL of the Kiel classification were included in this study. The investigations were performed on slides stained with Pappenheim (May-Grünwald-Giemsa) or conventional cytochemical techniques for substrate and enzyme demonstration, such as periodic acid Schiff (PAS), neutral and acid non-specific alphanaphthyl acetate esterase, and acid and alkaline phosphatase. In certain cases further techniques for substrate and enzyme demonstration, including myeloperoxidase and naphthol AS-D chloroacetate esterase, were used. We combined the cytologic and cytochemical evaluation with an attempt to diagnose the type of lymphoma on imprints without prior knowledge of the histologic findings or clinical data, in other words, blind. At the same time, we attempted to distinguish the NHL from reactive lymph node lesions, nonlymphoid malignant tumors, and systemic diseases. For this purpose, 75 cases of lymphadenitis and 33 cases of nonlymphoid neoplasia were mixed with the NHL for a blind test. In the following we will summarize the results pertaining to the NHL only. Chronic lymphocytic leukemia of B type (B-CLL; n = 75) was cytologically characterized by the presence of so-called prolymphocytes and paraimmunoblasts and a predominance of lymphocytes. In our opinion, there are four main variants of B-CLL: small-cell ("mature") CLL, a type in which prolymphocytes are plentiful ("immature" CLL), LP immunocytoma-like ("basophilic") CLL, and a type of CLL with centrocyte-like lymphocytes ("B2-CLL"). B-CLL had no cytochemical profile of its own. The reproducibility of the diagnosis on imprints was 80%. In prolymphocytic leukemia of B type (B-PLL; n = 1) prolymphocytes and blast cells were plentiful. In the case studied, acid phosphatase activity was moderately strong (evident as granules distributed in a semicircular fashion and focally accumulated). In the blind test we diagnosed it only descriptively as an "acid phosphatase-rich lymphoma of low-grade malignancy with a high prolymphocyte and blast cell content". Chronic lymphocytic leukemia of T type (T-CLL) and prolymphocytic leukemia of T type (T-PLL) could not be distinguished with certainty in sections or imprints. There was also no strict delineation between T-CLL and T-PLL in blood smears. The T-CLL and T-PLL cases we evaluated (n = 4) belonged to the so-called helper cell type.(ABSTRACT TRUNCATED AT 400 WORDS)
对442例非霍奇金淋巴瘤（NHL）患者的淋巴结和肿瘤标本印片进行了细胞学和细胞化学评估。除毛细胞白血病、特殊形式的外周多形性T细胞淋巴瘤和淋巴结浆细胞瘤外，本研究纳入了基尔分类中的所有类型NHL。研究采用帕彭海姆（May-Grünwald-Giemsa）染色玻片或传统细胞化学技术来显示底物和酶，如过碘酸希夫（PAS）、中性和酸性非特异性α萘乙酸酯酶以及酸性和碱性磷酸酶。在某些情况下，还使用了其他显示底物和酶的技术，包括髓过氧化物酶和萘酚AS-D氯乙酸酯酶。我们将细胞学和细胞化学评估相结合，尝试在不了解组织学结果或临床数据的情况下，即盲目地对印片进行淋巴瘤类型诊断。同时，我们试图将NHL与反应性淋巴结病变、非淋巴恶性肿瘤和全身性疾病区分开来。为此，将75例淋巴结炎和33例非淋巴肿瘤与NHL混合进行盲法检测。以下我们仅总结与NHL相关的结果。B型慢性淋巴细胞白血病（B-CLL；n = 75）在细胞学上的特征是存在所谓的原淋巴细胞和副免疫母细胞，且淋巴细胞占优势。我们认为，B-CLL有四种主要变体：小细胞（“成熟”）CLL、原淋巴细胞丰富的类型（“不成熟”CLL）、LP免疫细胞瘤样（“嗜碱性”）CLL以及具有中心细胞样淋巴细胞的CLL类型（“B2-CLL”）。B-CLL没有其自身的细胞化学特征。印片诊断的可重复性为80%。B型原淋巴细胞白血病（B-PLL；n = 1）中原淋巴细胞和母细胞丰富。在所研究病例中，酸性磷酸酶活性中等强度（表现为呈半圆形分布并局部聚集的颗粒）。在盲法检测中，我们仅将其描述性诊断为“低度恶性、富含酸性磷酸酶、原淋巴细胞和母细胞含量高的淋巴瘤”。T型慢性淋巴细胞白血病（T-CLL）和T型原淋巴细胞白血病（T-PLL）在切片或印片中无法确切区分。在血涂片中，T-CLL和T-PLL之间也没有严格界限。我们评估的T-CLL和T-PLL病例（n = 4）属于所谓的辅助细胞类型。
