Moriarty A T, Schwenk G R, Chua G
Department of Pathology, Methodist Hospital of Indiana, Indianapolis 46206.
Acta Cytol. 1993 Mar-Apr;37(2):191-6.
Splenic fine needle aspiration biopsy (FNAB) is rarely performed in the United States for several reasons: there is a perception that there is an increased risk of bleeding, and rendering a diagnosis of lymphoma (the most common primary splenic neoplasm) by FNAB is controversial. During a three-year period, we saw 11 cases of splenic FNAB. We present four cases of lymphoreticular neoplasms occurring between 1988 and 1991 in which the spleen was the only or most accessible organ in which to establish a diagnosis by FNAB: one case of small cleaved cell lymphoma, two cases of immunoblastic lymphoma (one T cell, one B cell by immunophenotyping studies) and one case of hairy cell leukemia in which the disease was confined to the spleen. All FNABs were radiologically guided, none of the patients suffered significant complications, and all had specimens sufficiently cellular to establish the diagnosis. Splenic puncture with FNAB may be an important and underutilized procedure for establishing a diagnosis in patients who have undetectable disease at other sites.
在美国，脾脏细针穿刺活检（FNAB）很少进行，原因有以下几点：人们认为出血风险会增加，而且通过FNAB诊断淋巴瘤（最常见的原发性脾脏肿瘤）存在争议。在三年时间里，我们共诊治了11例脾脏FNAB病例。我们呈现4例1988年至1991年间发生的淋巴网状肿瘤病例，在这些病例中，脾脏是通过FNAB进行诊断的唯一或最易取材的器官：1例小裂细胞淋巴瘤，2例免疫母细胞淋巴瘤（通过免疫表型研究，1例为T细胞型，1例为B细胞型），以及1例毛细胞白血病，该病例中疾病仅局限于脾脏。所有FNAB均在放射学引导下进行，所有患者均未出现严重并发症，且所有标本的细胞数量均足以进行诊断。对于在其他部位未检测到病变的患者，通过FNAB进行脾脏穿刺可能是一种重要但未得到充分利用的诊断方法。
