细针针吸细胞学诊断精子肉芽肿的临床价值

Clinical Value in Diagnosis of Sperm Granuloma by Fine-needle Aspiration Cytology

目的 探讨细针针吸细胞学诊断精子肉芽肿的临床价值,了解精子肉芽肿细胞形态的变化特点.方法 采用细针针吸细胞学方法观察48例男性附睾病变,并与组织病理学进行对照.结果 48例经病理诊断为精子肉芽肿,其中44例经细针针吸细胞学诊断精子肉芽肿,与病理符合率91.67%,另有4例因穿刺涂片细胞成分较少未作明确诊断.根据不同细胞浸润程度和病情的进展情况,将精子细胞肉芽肿分为中性粒细胞浸润期（早期）、淋巴-组织细胞浸润期（中期）和纤维细胞增殖期（晚期）,早期、中期、晚期是精子肉芽肿的不同阶段的病理变化过程,随着病情发展,早期向中期、晚期转化.结论 细针针吸细胞学诊断精子肉芽肿准确率高,方法简单,病人较易接受,适合推广应用.

Objective To explore the clinical value in the diagnosis of sperm granuloma by fine-needle aspiration cytology （FNAC） and the characteristics of morphological changes in sperm granuloma. Methods 48 male patients of epididymal lesions were observed by FNAC and contrasted with histopathology. Results 48 cases were pathologically diagnosed as sperm granuloma of which,44 cases were diagnosed as sperm granuloma by FNAC,the other 4 cases were failed by FNAC for fewer smeared cells. The coincidence rate between FNAC and histopathology was 91.67%. According to the degree of inflammatory cell infiltration and development of the disease,sperm granuloma was divided into three stages： neutrophil infiltration stage （early stage）,lymph-histiocyte infiltration stage （medium stage） and fibroblast proliferation stage （last stage）. In addition, these three stages were the different periods in the pathological changes of sperm granuloma, and the early stage could turn into the medium stage and the last stage along with the disease progression. Conclusion FNAC in the diagnosis of sperm granuloma is recommendable for its high accuracy,simple operation,and the easier acceptance of patients.