Abstract：
BACKGROUND: To explore the value of cell morphology, immunophenotype, and gene alterations of serosal effusion in the diagnosis of lymphoma.
METHODS: Serosal effusion of 69 cases of lymphoma patients were collected, including 36 cases with malignant effusion and 33 cases with nonmalignant effusion. Ordinary cytology, liquid-based cytology, cellblock, and immunocytochemical staining were performed in each case, some cases were detected by fluorescence in situ hybridization for C-MYC, BCL2, and BCL6 gene translocations. T/B cell ratio in malignant and nonmalignant serosal effusions was analyzed and compared by flow cytometry (FCM) and immunohistochemical (IHC), respectively. The prognostic value of serous effusion in diffuse large B-cell lymphoma (DLBCL) was investigated and another 20 DLBCL cases without effusion were successively selected as control.
RESULTS: The number of naive lymphocytes, apoptotic bodies, and mitotic figures were more common in malignant effusions compared with nonmalignant effusions (p < .01). The top three lymphomas in malignant effusion were DLBCL (19/36, 52.8%), mantle cell lymphoma (MCL) (4/36, 11.1%, 3 blastoid variant) and high-grade B-cell lymphoma (HGBL) (4/36, 11.1%). T/B cell ratio by FCM analysis ranged from 0.00 to 0.55 (mean 0.084) in malignant effusion, and 2.58 to 984.00 (mean 249.9) in nonmalignant effusion. The difference was significant (p = .017). The T/B cell ratio by IHC analysis ranged from 0.02 to 3.00 (mean 0.200) in malignant effusion, and 2.00-100.00 (mean 34.10) in nonmalignant effusion. The difference was significant (p = .017). In the effusions involving DLBCL, most effusions were present at the time of diagnosis (57.9%); single pleural effusions were more common (36.8%). The median overall survival times of patients with malignant effusion, nonmalignant effusion and DLBCL without serous effusion were 11, 17, and 23 months respectively (p = .04). Three patients of HGBL died, and the overall survival times were 5, 8, and 9 months, respectively.
CONCLUSIONS: The cytomorphological characteristics combined with immunophenotype, FCM, gene rearrangement, and other tests can diagnose and classify patients with effusion as the first symptom. The T/B cell ratio is less than 1 by FCM or IHC suggesting a malignant serosal effusion. The presence of malignant effusion in DLBCL patients is an important clue for poor prognosis.
METHODS: Serosal effusion of 69 cases of lymphoma patients were collected, including 36 cases with malignant effusion and 33 cases with nonmalignant effusion. Ordinary cytology, liquid-based cytology, cellblock, and immunocytochemical staining were performed in each case, some cases were detected by fluorescence in situ hybridization for C-MYC, BCL2, and BCL6 gene translocations. T/B cell ratio in malignant and nonmalignant serosal effusions was analyzed and compared by flow cytometry (FCM) and immunohistochemical (IHC), respectively. The prognostic value of serous effusion in diffuse large B-cell lymphoma (DLBCL) was investigated and another 20 DLBCL cases without effusion were successively selected as control.
RESULTS: The number of naive lymphocytes, apoptotic bodies, and mitotic figures were more common in malignant effusions compared with nonmalignant effusions (p < .01). The top three lymphomas in malignant effusion were DLBCL (19/36, 52.8%), mantle cell lymphoma (MCL) (4/36, 11.1%, 3 blastoid variant) and high-grade B-cell lymphoma (HGBL) (4/36, 11.1%). T/B cell ratio by FCM analysis ranged from 0.00 to 0.55 (mean 0.084) in malignant effusion, and 2.58 to 984.00 (mean 249.9) in nonmalignant effusion. The difference was significant (p = .017). The T/B cell ratio by IHC analysis ranged from 0.02 to 3.00 (mean 0.200) in malignant effusion, and 2.00-100.00 (mean 34.10) in nonmalignant effusion. The difference was significant (p = .017). In the effusions involving DLBCL, most effusions were present at the time of diagnosis (57.9%); single pleural effusions were more common (36.8%). The median overall survival times of patients with malignant effusion, nonmalignant effusion and DLBCL without serous effusion were 11, 17, and 23 months respectively (p = .04). Three patients of HGBL died, and the overall survival times were 5, 8, and 9 months, respectively.
CONCLUSIONS: The cytomorphological characteristics combined with immunophenotype, FCM, gene rearrangement, and other tests can diagnose and classify patients with effusion as the first symptom. The T/B cell ratio is less than 1 by FCM or IHC suggesting a malignant serosal effusion. The presence of malignant effusion in DLBCL patients is an important clue for poor prognosis.
摘要：
背景：为了探索细胞形态学的价值，免疫表型,浆膜积液在淋巴瘤诊断中的基因改变。
方法:收集69例淋巴瘤患者的血清积液,其中恶性积液36例，非恶性积液33例。普通细胞学,液基细胞学，cellblock,并在每种情况下进行免疫细胞化学染色，一些病例通过荧光原位杂交检测到C-MYC，BCL2和BCL6基因易位。通过流式细胞术（FCM）和免疫组织化学（IHC）分析和比较恶性和非恶性浆膜积液中的T/B细胞比率，分别。研究了浆液性积液在弥漫性大B细胞淋巴瘤（DLBCL）中的预后价值，并连续选择20例无积液的DLBCL作为对照。
结果：幼稚淋巴细胞的数量，凋亡体，与非恶性积液相比，恶性积液和有丝分裂特征更常见（p<0.01）。恶性积液中排名前3位的淋巴瘤为DLBCL(19/36,52.8%),套细胞淋巴瘤（MCL）（4/36，11.1%，3囊样变异）和高级别B细胞淋巴瘤（HGBL）（4/36，11.1％）。通过FCM分析，恶性积液的T/B细胞比率为0.00至0.55（平均0.084），非恶性积液为2.58至984.00（平均249.9）。差异显著(p=0.017)。通过IHC分析，恶性积液中的T/B细胞比率为0.02至3.00（平均0.200），在非恶性积液中，为2.00-5.00（平均34.10）。差异显著(p=0.017)。在涉及DLBCL的积液中，大多数积液在诊断时出现（57.9％）；单发胸腔积液更为常见（36.8％）。恶性积液患者的中位总生存时间，非恶性积液和无浆液性积液的DLBCL分别为11、17和23个月(p=.04)。3名HGBL患者死亡,总生存时间分别为5、8和9个月，分别。
结论：细胞形态学特征结合免疫表型，FCM,基因重排，和其他测试可以诊断和分类的病人有积液为首发症状。通过FCM或IHC，T/B细胞比率小于1，表明恶性浆膜积液。DLBCL患者存在恶性积液是预后不良的重要线索。
方法:收集69例淋巴瘤患者的血清积液,其中恶性积液36例，非恶性积液33例。普通细胞学,液基细胞学，cellblock,并在每种情况下进行免疫细胞化学染色，一些病例通过荧光原位杂交检测到C-MYC，BCL2和BCL6基因易位。通过流式细胞术（FCM）和免疫组织化学（IHC）分析和比较恶性和非恶性浆膜积液中的T/B细胞比率，分别。研究了浆液性积液在弥漫性大B细胞淋巴瘤（DLBCL）中的预后价值，并连续选择20例无积液的DLBCL作为对照。
结果：幼稚淋巴细胞的数量，凋亡体，与非恶性积液相比，恶性积液和有丝分裂特征更常见（p<0.01）。恶性积液中排名前3位的淋巴瘤为DLBCL(19/36,52.8%),套细胞淋巴瘤（MCL）（4/36，11.1%，3囊样变异）和高级别B细胞淋巴瘤（HGBL）（4/36，11.1％）。通过FCM分析，恶性积液的T/B细胞比率为0.00至0.55（平均0.084），非恶性积液为2.58至984.00（平均249.9）。差异显著(p=0.017)。通过IHC分析，恶性积液中的T/B细胞比率为0.02至3.00（平均0.200），在非恶性积液中，为2.00-5.00（平均34.10）。差异显著(p=0.017)。在涉及DLBCL的积液中，大多数积液在诊断时出现（57.9％）；单发胸腔积液更为常见（36.8％）。恶性积液患者的中位总生存时间，非恶性积液和无浆液性积液的DLBCL分别为11、17和23个月(p=.04)。3名HGBL患者死亡,总生存时间分别为5、8和9个月，分别。
结论：细胞形态学特征结合免疫表型，FCM,基因重排，和其他测试可以诊断和分类的病人有积液为首发症状。通过FCM或IHC，T/B细胞比率小于1，表明恶性浆膜积液。DLBCL患者存在恶性积液是预后不良的重要线索。
