Patil P S, Bem C
Department of Pathology, School of Medicine, University of Zambia, Lusaka.
J Clin Pathol. 1993 Sep;46(9):806-9. doi: 10.1136/jcp.46.9.806.
To study the value of wide needle (19 gauge) aspiration cytology in the diagnosis of lymph node disease in Zambia in the absence of a trained cytologist.
Patients (n = 304) referred for surgical biopsy of an enlarged peripheral lymph node were studied prospectively. Surgical biopsy was routinely preceded by 19 gauge needle aspiration of the same node; aspirates were stained by haematoxylin and eosin and Ziehl Neelsen stains.
Of 232 aspirates, 182 contained sufficient material for cytological characterisation. Tuberculosis was diagnosed or suspected in 122 of 126 aspirates with histologically confirmed tuberculous lymphadenitis; reactive follicular hyperplasia in 31 of 38 patients with primary HIV lymphadenopathy; malignancy in all five patients with malignant nodes; and Kaposi's disease in four of nine patients with this. Tuberculous lymphadenitis was falsely suspected in four patients, as was reactive follicular hyperplasia in four, and Kaposi's disease in four.
Wide needle aspiration cytology is useful in the diagnosis of lymphadenopathy in Central Africa, with the exception of lymphadenopathic Kaposi's disease.
在没有专业细胞病理学家的情况下，研究粗针（19号）穿刺细胞学检查在赞比亚淋巴结疾病诊断中的价值。
对304例因外周淋巴结肿大而接受手术活检的患者进行前瞻性研究。在进行手术活检前，常规先用19号针穿刺同一淋巴结；穿刺物用苏木精和伊红染色以及齐-尼氏染色。
在232份穿刺物中，182份含有足够用于细胞学特征分析的材料。在126份组织学确诊为结核性淋巴结炎的穿刺物中，122份诊断或怀疑为结核病；在38例原发性HIV淋巴结病患者中，31例为反应性滤泡增生；5例恶性淋巴结患者均诊断为恶性肿瘤；9例患有卡波西肉瘤的患者中有4例诊断为此病。4例患者被误诊为结核性淋巴结炎，4例被误诊为反应性滤泡增生，4例被误诊为卡波西肉瘤。
除淋巴结病性卡波西肉瘤外，粗针穿刺细胞学检查在中非淋巴结疾病的诊断中有用。
