非霍奇金淋巴瘤骨髓侵犯细胞形态学和免疫表型分析

Analysis of morphology and immunophenotype of bone marrow involvement of non-Hodgkin′s lymphoma

目的探讨骨髓细胞形态学和免疫表型在诊断非霍奇金淋巴瘤骨髓浸润中的价值。方法采用骨髓涂片和流式细胞术联合检测非霍奇金淋巴瘤(NHL)骨髓侵犯(BMI)。骨髓涂片经瑞氏-吉姆萨液染色,分类计数4种类型NHL细胞:小细胞成熟细胞型、大细胞幼稚型、大细胞原始型、组织细胞型。采用流式细胞术经FSC、SSC、McAb1-FITC、McAb2-PE、CD45-Percp五参数分析,确定免疫表型。结果 38例NHL分别被诊断为B细胞淋巴瘤28例、T细胞淋巴瘤7例、NK细胞淋巴瘤2例,间变性大细胞淋巴瘤1例。38例NHL细胞骨髓侵犯的骨髓细胞形态学分型结果为小细胞成熟型25例(65.8%)、大细胞幼稚型3例(7.9%)、大细胞原始型6例(15.8%)、组织细胞型4例(10.5%)。结论应用骨髓细胞形态学和流式细胞术联合检测NHL-BMI,可以提高诊断的准确性并提供相应的病理分型意见。

Objective To research the value of morphology and immunophenotype of bone marrow involvement（BMI） of non- Hodgkin＇s lymphoma（NHL）. Methods Combined examination of bone marrow smear and flow cytometry（FCM）were used to de- tect the BMI of NHL. Bone marrow smears were stained by Wright Giemsa staining solution and tumor cells of NHL were differen- tially counted under optical microscope. Cells of NHL were divided into 4 types in bone marrow： Small mature lymphoma cells types,large immature lymphoma cells types,large primitive lymphoma cells types,and histiocyte types. Five analysis parameters in FCM including FSC, SSC, McAbl-FITC, McAb2-PE,and CD45-Percp were used to determine the immunophenotype of N HL cells. Results 28 cases of B-cell lymphoma,7 cases of T-cell lymphoma,2 cases of NK cell lymphoma, 1 case of anaplastic large cell lym- phoma（ALCL） were diagnosed in 38 cases of NHI. with BM1. There were 25 cases of small mature lymphoma cells types（ 65.8 % ）, 3 cases of large immature lymphoma cells types（7.9%）,6 cases of large primitive lymphoma cells types（15.8%）,and 4 cases of histiocyte types（ 10.5 ~） classified by using bone marrow cell morphology detection. Conclusion Combination of bone marrow cell morphology and FCM in the detecting of NHI.-BMI could improve the diagnostic accuracy and provide views of the pathological classification.