超声引导恶性淋巴瘤穿刺活检

Ultrasound - guided Biopsy of Malignent Lymphoma Leision

目的:探讨超声引导穿刺深部病灶活检确诊淋巴瘤的价值。方法:21例患者,纵膈、后腹膜、肝、脾、肾、肾上腺实性肿块,在超声引导下用18G或16G活检枪穿刺取材,常规HE染色,光镜检查,部分加作免疫组织化学检查。结果:超声引导下穿刺确诊为恶性淋巴瘤15例,诊断阳性率71％(15/21),假阴性6例。其中1次取材阳性率54％,2次取材阳性率88％,2例重复活检患者均明确诊断。常规加免疫组化染色的淋巴瘤诊断阳性率81％。3例标本有淋巴瘤分型。结论:超声引导下淋巴瘤病灶穿刺活检,具有确诊率较高,并发症较少的优点,对淋巴瘤深部病灶的确诊很有帮助,多点取材、重复活检及免疫组织化学检查有助提高淋巴瘤的诊断率。

Objective: To evaluate the value of ultrasound - guided biopsy of deep - located lesion in the diagnosis of lym-phoma. Methods:Twenty - one patients with solid space - occupied lesions, which including mediastinal, abdominal, liver, spleen, kidney and adrenal were referred for biopsy under ultrasound guidance using 18G or 16G biopsy gun. Pathology examination included hematoxylin and eosin staining and immunohistochemical staining. Results: Fifteen patients were diagnosed lymphoma. The rate of positive diagnosis was 71%(average), 54%(one sample), 88%(two samples)and 81%(immunostain-ing).Two patients were diagnosed by repeat biopsy,and three patients were diagnosed with lymphoma subclassification. Conclusion : Biopsy of deeply located lymphoma mass under ultrasound guidance has high diagnostic accuracy and low complication rate. Several samples, repeat biopsy and immunostaining are useful for diagnosis.