IMMUNOLOGICAL METHODS IN CYTOLOGY - DEFINITIVE DIAGNOSIS OF NON-HODGKINS LYMPHOMAS USING IMMUNOLOGICAL MARKERS FOR T-CELLS AND B-CELLS
IMMUNOLOGICAL METHODS IN CYTOLOGY - DEFINITIVE DIAGNOSIS OF NON-HODGKINS LYMPHOMAS USING IMMUNOLOGICAL MARKERS FOR T-CELLS AND B-CELLS
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DOI：
10.1093/ajcp/82.6.666
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发表时间：
1984-01-01
影响因子：
3.5
通讯作者：
CHU, EW
中科院分区：
文献类型：
--
作者：
MARTIN, SE;ZHANG, HZ;CHU, EW
恶性淋巴瘤的细胞学诊断可能非常困难，因为小细胞淋巴瘤和混合的小细胞和大细胞淋巴瘤的恶性细胞的细胞学特征可能与反应性淋巴细胞的特征难以区分。此外，在细胞学标本中，大细胞淋巴瘤很难与未分化癌区分开来。使用亲和素-生物素免疫过氧化物酶技术和针对B细胞标志物α、γ的抗体。和.MU。H链和.kappa。还有.Lambda。应用L链、T细胞标记物Leu-1、Leu-2a、Leu-3a、淋巴标记物T200、末端脱氧核苷酸转移酶TdT和Leu-M3，对35例胸水、脑脊液、腹水和细针抽吸细胞学标本进行检测。免疫染色使他们能够在每个研究病例中做出淋巴瘤或反应性积液的明确诊断，并导致超过50%的病例的形态诊断有了显着改进。16例淋巴细胞为单克隆性B细胞：10例表达IgMα，4例表达IgMα，1例表达IgAα，1例表达αkappa。没有明显的H链表达。虽然目前尚无良好的T细胞非克隆性标志物，但2例T细胞淋巴系统恶性肿瘤的异常表型表达可确诊为T细胞淋巴瘤。1例普通型ALL和1例淋巴母细胞性淋巴瘤TDT的表达证实了其诊断。在一例零细胞大细胞淋巴瘤患者中，T200在恶性细胞上的表达排除了癌症的可能性。在15例患者中，标记物研究显示有反应性淋巴组织增殖。免疫标记物在淋巴瘤的细胞学诊断中是非常有用的。
Cytologic diagnosis of malignant lymphoma can be extremely difficult because the cytologic features of the malignant cells in small cell and mixed small and large cell lymphomas may be indistinguishable from those of reactive lymphoid cells. In addition, large cell lymphoma can be difficult to distinguish from undifferentiated carcinoma in cytologic specimens. Using the avidin-biotin immunoperoxidase technique and antibodies to the B cell markers .alpha., .gamma. and .mu. H chains and .kappa. and .lambda. L chains, to the T cell markers Leu-1, Leu-2a and Leu-3a, to the lymphoid marker T200, to TdT [terminal deoxynucleotidyl transferase] and to Leu-M3, were used to study 35 cytologic specimens including pleural, cerebrospinal, and ascites fluids and fine-needle aspirations. Immunologic staining allowed them to make a definitive diagnosis of lymphoma or reactive effusion in every case studied and resulted in a significant modification of the morphologic diagnosis in over 50% of cases. In 16 cases the lymphoid cells were monoclonal B cells: 10 expressing IgM .kappa.; 4 expressing IgM .lambda.; 1 expressing IgA .kappa.; and 1 expressing .kappa. without demonstrable H chain expression. Although there are no good markers of nonoclonality for T cells, a positive diagnosis was made in 2 cases of T cell lymphoid malignancies by the expression of an aberrant phenotype on the malignant cells. The expression of TdT confirmed the diagnosis in 1 case of common ALL [acute lymphoblastic leukemia] and 1 lymphoblastic lymphoma. In a patient with a null cell large cell lymphoma, the expression of T200 on the malignant cells ruled out the possibility of carcinoma. In 15 cases the marker studies indicated a reactive lymphoid proliferation. Immunologic markers are apparently very useful in the cytologic diagnosis of lymphoma.