超声引导下脾脏穿刺活检的诊断价值

Diagnostic value of spleen biopsy under ultrasound guidance

目的探讨超声引导下脾脏穿刺活检的诊断价值。方法分析22例超声引导下脾脏穿刺活检患者,局灶性病变10例,弥漫性病变12例,合并腹膜后多发肿大淋巴结12例;每例穿刺1～4次,标本进行病理学诊断,14例行免疫组化染色,其中1例行脾切除手术。结果标本满意率100%,诊断准确率90.9%(20/22),其中淋巴瘤脾脏浸润8例,原发脾淋巴瘤1例,炎性改变8例,海蓝组织增生症1例,未见肿瘤3例,血管肉瘤1例。穿刺后未出现严重并发症。结论超声引导下穿刺是脾脏病变安全有效的诊断方法 ,可以作为这些疾病的常规诊断方法 。

Objective To explore the diagnostic value of spleen biopsy under ultrasound guidanee. Methods Twenty - two cases of spleen biopsy under ultrasound guidance were analyzed retrospectively. There were 10 cases of focal lesion, 12 cases of diffused lesion, and 12 cases were combined with retroperitoneal lymphadenectasis. 1 - 4 times puncture were performed in each case, then pathological diagnosis was peffoImed in all the cases, immunohistoehemical stain was performed in 14 cases, one case of them underwent operation. Results The satisfaction rate of all samples was 100% , the diagnostic rate was 90.9% （20/22） , including 8 cases of lymphoma with spleen infiltration, 1 case of essential lymphoma,8 cases of inflammation, 1 case of sea - blue histocytosis, 3 eases without tumor infiltration, and 1 case of hemangiosareoma. No serious complication appeared after puncture. Conclusion Spleen biopsy under ultrasound guidance is a safe and effective method for spleen disease diagnosis, and it could be a routine diagnostic method in clinic.