摘要
目的探讨骨髓涂片和骨髓活检在非霍奇金淋巴瘤(NHL)骨髓浸润诊断中的价值。方法 NHL患者同时做骨髓涂片和骨髓活检。骨髓涂片经瑞氏染色,分类计数肿瘤细胞;骨髓切片采用塑料包埋法,制作组织切片,常规HGF染色。结果 62例NHL患者经骨髓涂片和骨髓活检联合检测,确诊为NHL细胞骨髓侵犯,其中49例(79.0%)骨髓涂片检出NHL细胞,59例(95.2%)骨髓活检检出肿瘤细胞浸润灶,骨髓活检阳性率略高于骨髓涂片,但差异无统计学意义(P>0.05)。NHL细胞形态分为4种类型:小细胞成熟型、大细胞幼稚型、大细胞原始型和组织细胞型。13例骨髓涂片检查阴性而骨髓活检阳性的病例中,10例是小细胞成熟型(76.9%);9例为骨髓淋巴瘤细胞轻度侵犯(69.2%),3例为重度侵犯合并骨髓纤维化(23.1%)。结论骨髓涂片和骨髓活检都是诊断NHL骨髓侵犯的重要手段,两者各有优势,联合应用可以提高诊断阳性率。骨髓活检在淋巴瘤细胞轻度骨髓侵犯或合并骨髓纤维化,以及浸润瘤细胞为小细胞成熟型时,更能准确地提供诊断依据。
Objective To explore the value of combined detection of bone marrow smear（BMS） and bone marrow biopsy（BMB） in the diagnosis of bone marrow（BM） infiltration of non-Hodgkin lymphoma（NHL）. Methods Patients with NHL were detected by BMS and BMB simultaneously. Smears were stained with Wright-Giemsa＇s staining to differentially count neoplastic cells and tissue sections were embedded in plastic and stained with HGF and gomori staining. Results 62 cases of patients with BM infiltration（BMI） of NHL were definitely diagnosed by the combined detection BMA and BMB. The detection rates of BMS and BMB for BMI of NHL were 79.0% and 95.2% respectively,and there was no statistical difference of detection rate between the two methods （P〉0.05）. Neoplasitc cells of NHL could be divided into 4 types,according to the morphology typing,including small mature lymphoma cells,mega immature lymphoma ceilS, mega-primitive lymphoma cells and histiocytes type. 13 cases were negative by BMB detection, but positive by BMA detection,including 10 （ 76.9% ） cases for small mature lymphoma cells type, 9 （ 69.2 % ） cases for slight BMI and 3（23. 1%） cases for severe BMI with myelofibrosis. Conclusion Both BMA and BMB are useful to diagnose BMI of NHL. Each of them has individual characteristics. Combined detection of these two methods can increase the diagnostic positive rates. BMB might offer diagnostic reference more accurately for the diagnosis of HNL with small mature lymphoma cells, slight BMI or severe BMI with myelofihrosis, compared with BMS.
出处
《国际检验医学杂志》
CAS
2011年第11期1195-1196,1198,共3页
International Journal of Laboratory Medicine
关键词
淋巴瘤
非霍奇金
活组织检查
骨髓浸润
骨髓涂片
lymphoma, non- Hodgkin
biopsy
bone marrow involvement
bone marrow smear
