Young N A, Al-Saleem T I, Ehya H, Smith M R
Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Cancer. 1998 Aug 25;84(4):252-61.
The primary diagnosis of non-Hodgkin's lymphoma/leukemia (NHL) by fine-needle aspiration (FNA) is controversial. The authors reviewed their experience with FNA and flow cytometry (FC) to determine the usefulness and limitations of these techniques in the diagnosis of NHL.
Slides and reports from all lymph node and extranodal FNAs performed during the period July 1993 to January 1997 with a diagnosis of lymphoma or benign lymphoid process were reviewed. Clinical and biopsy follow-up data were recorded. Results were tabulated and the usefulness of cytology was analyzed.
There were 100 adequate aspirates from 87 patients. These included 72 cases of NHL, 58 (80%) of which were diagnosed by FNA and FC without the need for histologic sampling (69% of the primary lymphomas and 88% of the recurrent lymphomas). There were 22 aspirates suspicious for lymphoma, 12 equivocal results, and 7 benign diagnoses. Eighty-six percent of malignant FNAs (50 of 58) had flow cytometry (FC) as compared with only 15% (5 of 34) of the suspicious or equivocal FNAs.
FNA is a valuable method for diagnosing and subclassifying NHL, although immunophenotyping by FC is often an essential ancillary test. In our experience, correlating the FNA results with the FC results can eliminate the need for a more invasive surgical biopsy in many cases.
细针穿刺抽吸活检（FNA）用于非霍奇金淋巴瘤/白血病（NHL）的初步诊断存在争议。作者回顾了他们使用FNA和流式细胞术（FC）的经验，以确定这些技术在NHL诊断中的实用性和局限性。
回顾了1993年7月至1997年1月期间所有诊断为淋巴瘤或良性淋巴病变的淋巴结和结外FNA的玻片和报告。记录临床和活检随访数据。将结果制成表格并分析细胞学的实用性。
87例患者中有100次足够的抽吸活检。其中包括72例NHL，其中58例（80%）通过FNA和FC诊断，无需组织学采样（原发性淋巴瘤为69%，复发性淋巴瘤为88%）。有22次抽吸活检结果可疑为淋巴瘤，12次结果不明确，7次为良性诊断。86%的恶性FNA（58例中的50例）进行了流式细胞术（FC）检测，而可疑或不明确的FNA中只有15%（34例中的5例）进行了该检测。
FNA是诊断和分类NHL的一种有价值的方法，尽管通过FC进行免疫表型分析通常是一项必不可少的辅助检查。根据我们的经验，在许多情况下，将FNA结果与FC结果相结合可以避免进行更具侵入性的手术活检。
