Laucirica R, Font R L
Department of Pathology, Methodist Hospital, Houston, TX, USA.
Diagn Cytopathol. 1996 Sep;15(3):241-5. doi: 10.1002/(SICI)1097-0339(199609)15:3<241::AID-DC13>3.0.CO;2-G.
The cytologic features of 46 lymphoproliferative ophthalmic lesions were evaluated using the "squash" technique and/or touch imprints at the time of frozen section. Of the 46 lesions, 33 were located in the orbit, 12 in the conjunctiva, and one in the eyelid. Fifteen cases were benign (reactive) hyperplasias, and 31 were diagnosed as malignant lymphoproliferative tumors. The cytologic features of the reactive group included a polymorphic lymphoid population intermixed with scattered tingible body macrophages. Within the malignant category, there were 28 malignant lymphomas. All 28 cases were diagnosed as non-Hodgkin's lymphomas. Cytologically, the malignant group consisted of a monomorphic population of atypical lymphoid cells. Of the 31 malignant lymphoid lesions, 58% (18 tumors) were small lymphocytic proliferations. The remaining 13 tumors were classified as follows: mixes small/large cell or pure large cell lymphomas (nine), plasmacytoma (three), and Burkitt's lymphoma (one). Final classification using the Working Formulation was made after evaluating the cytologic preparations and surgical material. In selected cases, the monoclonal nature of the malignant lymphoproliferative lesions was confirmed by flow cytometry and/or immunocytochemistry. Cytologic preparations of the fresh specimens preserve the morphologic details of the tumor cells, which is especially important when evaluating lymphoid lesions. Additionally, multiple smears can be prepared simultaneously for ancillary studies such as immunocytochemistry. Of our 46 lymphoproliferative lesions, two-thirds were diagnosed as malignant lymphomas. Based on the morphologic and immunophenotypic findings, all the malignant lymphomas were B-cell tumors, 50% of which were low grade using the Working Formulation.
在冰冻切片时，采用“压片”技术和/或触摸印片法对46例淋巴增生性眼部病变的细胞学特征进行了评估。46例病变中，33例位于眼眶，12例位于结膜，1例位于眼睑。15例为良性（反应性）增生，31例被诊断为恶性淋巴增生性肿瘤。反应性组的细胞学特征包括多形性淋巴细胞群与散在的吞噬细胞混合存在。在恶性病变类别中，有28例为恶性淋巴瘤。所有28例均被诊断为非霍奇金淋巴瘤。细胞学上，恶性组由单一形态的非典型淋巴细胞群组成。在31例恶性淋巴病变中，58%（18个肿瘤）为小淋巴细胞增生。其余13个肿瘤分类如下：小/大细胞混合或纯大细胞淋巴瘤（9个）、浆细胞瘤（3个）和伯基特淋巴瘤（1个）。在评估细胞学标本和手术材料后，采用工作分类法进行最终分类。在部分病例中，通过流式细胞术和/或免疫细胞化学证实了恶性淋巴增生性病变的单克隆性质。新鲜标本的细胞学标本保留了肿瘤细胞的形态细节，这在评估淋巴病变时尤为重要。此外，可同时制备多张涂片用于免疫细胞化学等辅助研究。在我们的46例淋巴增生性病变中，三分之二被诊断为恶性淋巴瘤。根据形态学和免疫表型结果，所有恶性淋巴瘤均为B细胞肿瘤，其中50%根据工作分类法为低级别肿瘤。
