脑膜淋巴瘤的临床脑脊液细胞学分析

Clinical Analysis of Cerebrospinal Fluid Cytology Meningeal Lymphoma

目的：探讨脑膜淋巴瘤的临床症状，分析脑脊液细胞学对脑膜淋巴瘤的诊断效果。方法对在我院收治的17例脑膜淋巴瘤患者进行脑脊液分析观察，将其编号为1～17号。利用脑脊液细胞学技术、免疫细胞化学方法以及流式细胞分析术对此17例脑膜淋巴瘤患者进行检测及分析。结果结果显示17例患者的脑脊液中都含有淋巴瘤细胞或变型的淋巴细胞。通过免疫细胞化学技术检测出有7例患者的脑脊液内很多细胞存在B细胞标志物。其中3号患者的多数细胞呈现CD34阳性，5号患者的CD20阳性细胞明显增多，11号患者的多数细胞呈现出CD19阴性和CD20阴性，其他患者的脑脊液内的细胞均呈现出CD4和CD8阴性或者很少细胞出现阳性。通过流式细胞分析技术得出，13号和17号患者的脑脊液内出现异常的克隆性B细胞。6例患有病毒性脑炎患者的脑脊液以及6例患有炎性脱髓鞘病患者的脑脊液细胞分析发现，其中有少于7%的CD19细胞呈阳性，多数阳性细胞为CD8和CD4。结论脑膜淋巴瘤的诊断主要依靠脑脊液细胞学，免疫细胞化学对脑膜淋巴瘤的诊断也有重要意义，流式细胞分析技术也可以帮助脑膜淋巴瘤的诊断。

Objective To investigate the clinical symptoms of meningeal lymphoma, diagnosis and analysis of effect of cerebrospinal lfuid cytology of leptomeningeal lymphoma. Methods To analysis of cerebrospinal fluid meningeal lymphoma patients were observed in 17 patients in our hospital, its number is 1~17. Cerebrospinal lfuid cytology, immunocytochemistry methods about 17 cases of meningeal lymphoma patients were detected and analysis of lfow cytometry. Results The results showed t hat the CSF of 17 patients with lymphoma cells or variant lymphocyte. By immunocytochemical detection technology of 7 patients with CSF in many cells in B cell markers. Most of these cells showed CD34 positive 3 patients, 5 patients with CD20 positive cells increased signiifcantly, majority of the cells in 11 patients showed CD19 negative and CD20 negative patients, cerebrospinal lfuid within the cells showed CD4 and CD8 negative or very few cells positive. By lfow cytometry analysis obtains, abnormal clonal B cells in cerebrospinal lfuid of 13 patients and 17 patients. Cerebrospinal lfuid of 6 patients with viral encephalitis patients and 6 cases of patients with inlfammatory demyelinating disease of the cerebrospinal lfuid cell analysis, which has less than 7% of CD19 cells were positive, the majority of cells positive for CD8 and CD4. Conclusion The diagnosis of meningeal lymphoma mainly rely on cerebrospinal lfuid cytology, also has an important signiifcance in diagnosis of meningeal lymphoma immunocytochemistry, lfow cytometry analysis diagnosis technology can also help leptomeningeal lymphoma.