摘要：

Introduction: Cytological findings from needle aspirations on 74 malignant lymphomas were compared with histological diagnoses. The two most important questions were: Cytomorphological criteria of the different types of lymphomas and the possibilities of classifying these criteria according to Rappaport's and Kiel nomenclature. Material and Methods: In 35 of the 74 patients aspiration biopsy was the first investigation of enlarged lymph nodes. In 39 patients aspiration biopsy was performed as the follow-up, and the primary diagnosis was known. Twenty cases were Hodgkin's disease. Fiftyfour cases of Non-Hodgkin's lymphoma were classified according to Rappaport and Kiel nomenclature. Biopsies and aspiration smears were examined separately by two investigators. The wet-fixed cytological smears were routinely stained according to Papanicolaou. Giemsa stain was done if necessary and was useful for the recognition of plasmocytoid features. Results: Hodgkin's disease was cytologically verified in 12 cases and suggested in five cases. In two cases no diagnosis was possible because of scanty material. One case of lymphadenitis was misinterpreted as Hodgkin's disease. There was good correlation of cytological and histological diagnoses on 50 Non-Hodgkin's lymphomas, according to the classifications mentioned above. There were only two cases in which cytological and histological diagnosis differed. Of the remaining four Non-Hodgkin's lymphomas, one case was cytologically false negative and the other was diagnosed falsely positive on cytology. In two other cases a tumor diagnosis was given, but the differential diagnosis between histiocytic lymphoma and large cell carcinoma was incorrect. In five cases out of 54 Non-Hodgkin's lymphoma, a cytologic or histologic diagnosis could not be established because of scanty or poorly preserved material. Discussion: Accurately processed smears are one of the most important means of establishing an exact cytological diagnosis of lymphoma. Hodgkin's cells and Reed-Sternberg giant cells are requiered for diagnosis of Hodgkin's disease. The mixed cellular pattern of Hodgkin's disease may differ only slightly from those cell pictures seen in reactive lymphadenopathy caused by viral infection, infectious mononucleosis, toxoplasmosis, hypersensitivity to Hydantoin medication, etc. In our laboratory, Non-Hodgkin's lymphomas are first classified according to the Kiel nomenclature. This nomenclature provides the clearest morphological criteria for the different lymphoid tumor cells. Absolute cell size, variation in size, and nuclear hyperchromasia are the most important features in recognition and differentiation of tumor cells in malignant lymphomas.

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