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目的 探讨骨髓和外周血检查在非霍奇金淋巴瘤 (NHL)诊断和分期中的价值。方法 对 10 3例NHL患者外周血、骨髓涂片采用瑞特染色 ,骨髓和淋巴结活检组织采用石蜡包埋切片、H -Giemsa -E染色和免疫组化分型。结果 10 3例NHL中 2 8例 (2 7 2 % )骨髓受累 (BMI)。其中 8例无明显浅表淋巴结肿大者经外周血、骨髓涂片及切片联合检查确诊为NHL ;7例原分期属Ⅰ期、Ⅱ期、Ⅲ期者经骨髓检查后归入Ⅳ期。淋巴瘤细胞形态多样 ,同一病例亦表现各异 ,大致分为原始细胞型、多形性淋巴细胞型、小淋巴细胞型、组织细胞样淋巴细胞型。与无BMI者相比 ,BMI者血细胞明显减少 ,骨髓三系造血明显抑制 ;无BMI者骨髓亦有激惹现象。结论 骨髓和外周血检查对NHL诊断和分期具有重要价值 ,特别是可能对无淋巴结病理患者提供诊断依据
Objective To investigate the value of bone marrow and peripheral blood in the diagnosis and staging of non-Hodgkin’s lymphoma (NHL). Methods The peripheral blood and bone marrow smears of 103 NHL patients were stained with Reiter stain. The bone marrow and lymph node biopsy specimens were obtained by paraffin embedded sections, H-Giemsa-E staining and immunohistochemical typing. Results Bone marrow involvement (BMI) was found in 28 of 32 (27.2%) NHL cases. Among them, 8 cases had no superficial lymph node enlargement and were diagnosed as NHL by peripheral blood, bone marrow smear and biopsy, and 7 cases with stage Ⅰ, Ⅱ and Ⅲ were classified as stage Ⅳ after bone marrow examination. Lymphoma cells in various shapes, the same case also showed different, roughly divided into primitive cell type, polymorphic lymphocyte type, small lymphocytic, histiocytoid lymphocyte type. Compared with non-BMI, BMI significantly decreased blood cells, bone marrow hematopoietic significantly inhibited; bone marrow without BMI also have irritation. Conclusion The examination of bone marrow and peripheral blood is of great value in the diagnosis and staging of NHL, especially for the diagnosis of non-lymph node patients