【摘 要】 目的 探讨淋巴瘤骨髓涂片与切片联合应用在淋巴瘤诊断和分期中的价值。方法 对114例淋巴瘤的外周血、骨髓液涂片采用瑞特染色、骨髓活检采用塑料包埋后半薄切片，常规化学染色。结果 7例霍奇金淋巴瘤骨髓涂片、切片均未见淋巴瘤细胞。107例非霍奇金淋巴瘤中32例(29.9%)骨髓受累。其中13例(40.6%)原分期属Ⅰ、Ⅱ和Ⅲ期，后经骨髓检查升至Ⅳ期；32例中5例无浅表淋巴结肿大者，经骨髓涂片及切片检查后确诊为NHL。在骨髓、外周血涂片中瘤细胞形态多样，同一份标本中也可各异。切片中骨髓受累可呈局灶型(81.3%)和弥漫型(18.7%)。其瘤细胞形态主要有五种:(1)小淋巴细胞为主型；(2)原始血细胞样淋巴细胞为主型；(3)多形性淋巴细胞为主型；(4)淋-浆样细胞为主型;(5)肉芽肿型。结论 骨髓涂片和切片相结合对淋巴瘤诊断和分期具有十分重要价值，特别是对无浅表淋巴结肿大或无其他组织病理依据时可提供诊断。

The value of combineduse of bone marrow smear and section in lymphoma

    for diagnosis and staging

    CUI Pingjiang, LOU Fangding, FU Yan.

    PLA General Hospital, Beijing 100853

【Abstract 】 Objective Toexplore the value of combined use of bone marrow smear and section in lymphoma fordiagnosis and staging. Methods Smears of peripheral blood and bonemarrow from 114 cases of lymphoma were stained according to Wright. Plastic embeddedsections of the 114 cases were stained according to HE, HGF and Gomori. Results Noneof the 7 patients with Hodgkin′s lymphoma ( HD ) presented bone marrow involvement,while 32(29.9%) of the 107 patients with Non-Hodgkin′s lymphoma ( NHL ) presented bonemarrow involvement, 13(40.6%) of the 32 cases in stage Ⅰ、Ⅱ、Ⅲ were promoted tostage Ⅳ after bone marrow examination. In 5 of the 32 patients without lymphadenopathythe diagnosis of lymphoma was established through bone marrow study. Lymphoma cells inbone marrow and peripheral blood varied in morphology . Bone marrow involvement might befocal(81.3%) or diffused (18.7%). There were mainly five type ：(1)Small lymphocyte type. (2)blast-like lymphocyte type.(3)multimorphology type. (4)lymphoplasmacytoid cell type. (5)granuloma type. Conclusion Bonemarrow examination is of importance in patients with known or suspected lymphomas and itmay be diagnostic in patients without lymphadenopathy or in cases with no conclusivehistological evidence from other sites.

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