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頁籤選單縮合
題名 | Examination of Pericardial Effusions by Cytology and Immunocytochemistry=心包積水之細胞學與免疫細胞化學檢查 |
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作者姓名(中文) | 陳立民; 趙祖怡; 江蓉華; 聶鑫; 張俊彥; 黃旭輝; 薛爾榮; 王成俊; | 書刊名 | 中華醫學雜誌 |
卷期 | 58:4 1996.10[民85.10] |
頁次 | 頁248-253 |
分類號 | 414.82 |
關鍵詞 | 細胞學; 免疫細胞化學; 心包積水; Cytology; Immunocytochemistry; Pericardial effusion; |
語文 | 英文(English) |
中文摘要 | 背景 心包積水之細胞學檢查在文獻上並不常見,而免疫細胞化學染 色在心包積水診斷上所扮演之角色文獻上報告更少。作者特別提出本身對心包 積水細胞學與免疫細胞化學檢查之結果。 方法 四年間,三軍總醫醫院共有36位患者50件心包積水標本接受細胞學檢 查,除Wright-Giemsa及/或Papanicolaou染色外,更進一步以免疫細胞化學染色 來確認細胞之本質。 結果 此36位患者中良性與惡性疾病患者各佔18位。其中8位良性及8位惡 性疾病患者更進一步接受心包切片檢查,心包積水中常見之細胞有中性球、淋 巴球、巨噬細胞與間皮細胞。惡性疾病患者之心包積水中除上述細胞外還可見 到腫瘤細胞。有時候反應性間皮細胞及巨噬細胞與腫瘤細胞不易區分,反應性 淋巴球與血液惡性腫瘤細胞類似,小而圓之腫瘤細胞更難僅以細胞形態來確認 它的本質。而以免疫細胞化學染色可有助於鑑別診斷。 結論 細胞學合併免疫細胞化學染色有很好的細胞診斷結果。尤其對某些惡性 腫瘤如肺小細胞癌與B細胞淋巴瘤,免疫細胞化學染色能更進一步確認腫瘤細 胞之本質。 |
英文摘要 | Background. Cytologic examination of pericardial effusions (PE) has been uncommonly reported in the literature. Fewer reports have studied the role of immunocytochemistry in diagnosis of PE. We described our experience, according to cytologic examination and immunocyto-chemical staining of PE. Methods. Over a four-year period, 50 PE specimens from 36 patients were examined cytologically by Wright-Giemsa stain and/or Papanicolaou stain, at Tri- Service General Hospital. Immunocytochemical stainings were further performed to ensure the cell nature. Results. Eighteen of these patients had benign etiologies; the others suffered from malignant diseases. Sixteen cases, including eight benign and eight malignant, received pericardial biopsy for comparison. Commonly encountered cells in PE with any kind of etiology included neutrophils, lymphocytes macrophages and mesothelial cells. Cancer cells were additionally seen in malignant PE, but not in all cases with cancers. Furthermore, reactive mesothelial cells and macrophages were sometimes not easily distinguished from cancer cells, and reactive lymphocytes frequently mimicked hematopoietic malignancies. Further, the nature of small round tumor cells can hardly be ensured by morphologic examination only. Immunocytochemical studies were successfully used to solve these dilemmas in some suspicious cases. Conclusions. This study showed that cytology together with clinical information and immunocytochemistry can achieve excellent sensitivity and specificity in identification of malignant PE. The use of immunocytochemistry can even ensure the nature of certain cancers such as small cell carcinoma and B cell lymphoma. |
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