Cytology of the Spleen in Fine-Needle Aspirates
Using very fine needles and a one-hand syringe permitting a very rapid procedure, the author has used fine-needle spleen biopsy as a routine clinical method without complications in a total material of more than 800 punctures. Overt hemorrhagic diathesis was regarded as an absolute contraindication, thrombocytosis and polycythemia were considered relative contraindications. The specimen obtained can be used only for smear preparations, not for histology.
A brief survey is given of the cell types to be expected in the smears and of the main cytologic patterns, which are of practical diagnostic importance. Such patterns are: myeloid metaplasia of different types, plasma cell reactions in immunopathic diseases including the rather specific cell formula of hemolytic anemias, the myeloma picture, the Hodgkin picture, the epitheloid cell granulomas and others. The label lymphocytic plethora was used for conditions with extremely high yields of lymphocytic cells. This concept embraces well-known neoplastic lymph proliferative disorders such as chronic lymphatic leukemia and lymph sarcoma, some interesting specific types of splenic lymphoma and non-neoplastic lymph proliferative reactions in many diseases. In splenic aspirates lymphocytic plethora represents a difficult but interesting diagnostic challenge.
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