印戒细胞淋巴瘤的细针穿刺抽吸。附鉴别诊断考量的病例报告。
Fine needle aspiration of signet-ring cell lymphoma. A case report with differential diagnostic considerations.
作者信息
Gilcrease M Z, Sahin M, Perri R T, Nelson F S, Guzman-Paz M
机构信息
Department of Laboratory Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
出版信息
Acta Cytol. 1998 Nov-Dec;42(6):1461-7. doi: 10.1159/000332188.
BACKGROUND
Signet-ring cell lymphoma is an unusual morphologic variant of non-Hodgkin's lymphoma that, although well described histologically, is scarcely mentioned in the cytology literature. Its main significance lies in its potential for diagnostic confusion with more common lesions containing signet-ring cells.
CASE
A 50-year-old, white male presented with a two-month history of persistent cervical lymphadenopathy and fatigue. Fine needle aspiration of a 2-cm, left, submandibular lymph node revealed classic signet-ring cells among small and large lymphoid cells. Also noted were multivacuolated cells. The background of the smears showed many vacuolated structures analogous to the lymphoglandular bodies seen in lymphoid proliferations without signet-ring cells.
CONCLUSION
The differential diagnosis of signet-ring cell lesions by fine needle aspiration includes signet-ring cell lymphoma, sinus histiocytosis and metastatic adenocarcinoma, liposarcoma and melanoma. When confronted with such an aspirate, additional material should be obtained for immunocytochemical or flow cytometric analysis.
背景
印戒细胞淋巴瘤是非霍奇金淋巴瘤一种罕见的形态学变异型，尽管其组织学特征已有详尽描述，但在细胞学文献中却鲜有提及。其主要意义在于它可能与含有印戒细胞的更常见病变在诊断上产生混淆。
病例
一名50岁白人男性，有持续两个月的颈部淋巴结肿大和疲劳病史。对左侧下颌下一个2厘米的淋巴结进行细针穿刺，在大小淋巴细胞中发现了典型的印戒细胞。还发现了多泡状细胞。涂片背景显示许多空泡状结构，类似于在无印戒细胞的淋巴组织增生中所见的淋巴腺小体。
结论
通过细针穿刺对印戒细胞病变进行鉴别诊断包括印戒细胞淋巴瘤、窦组织细胞增生症、转移性腺癌、脂肪肉瘤和黑色素瘤。当面对这样的穿刺样本时，应获取额外的材料进行免疫细胞化学或流式细胞术分析。
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