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Rolle der Zytologie in der hämatopathologischen Diagnostik

Role of cytology in hematopathological diagnostics

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Zusammenfassung

Die Zytologie stellt ein wichtiges diagnostisches Instrument in der täglichen Praxis der Hämatopathologie dar. Durch den zytologisch erfolgten Nachweis nichthämatologischer Ursachen einer Knotenbildung (z. B. Speicheldrüsenneoplasien, Tuberkulose, Melanom- oder Karzinommetastasen) besteht seltener die Notwendigkeit einer chirurgischen Exzision. Die kombinierte Anwendung morphologischer, immunphänotypischer sowie molekularer Analysen und der fachliche Austausch machen diese Untersuchungstechnik sicher. Somit stellt die zytologische Untersuchung in verschiedensten Situationen eine Alternative zur Exzisionsbiopsie dar – auch bei primären hämatologischen Erkrankungen und insbesondere bei Rezidiven.

Abstract

The role of cytology has so far been underrecognized in the diagnostic process of hematopathological questions. This article presents an algorithm which allows a stepwise work-up of cytology specimens obtained by minimally invasive ultrasound-guided fine needle aspiration in patients with unexplained lymph node swelling. Moreover, it is shown how the selective separation of cytology specimens allows the application of immunophenotypic analysis including flow cytometry and immunohistochemistry as well as molecular analyses, such as fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) strategies. With the integrative procedure presented, cytology offers an excellent cost-effective tool for the diagnostic approach of patients with suspected hematopathological malignancies allowing a high diagnostic accuracy, ideal for initial diagnosis or follow-up.

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Danksagung

Die Autoren bedanken sich bei Prof. D. Zimmermann und seinem Team sowie J. Roth für die Durchführung der molekulargenetischen Analysen.

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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  1. Institut für Klinische Pathologie, Universtitätsspital Zürich, Schmelzbergstr. 12, 8091, Zürich, Schweiz

    B. Bode & M. Tinguely

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  1. B. Bode
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  2. M. Tinguely
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Correspondence to B. Bode.

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Bode, B., Tinguely, M. Rolle der Zytologie in der hämatopathologischen Diagnostik. Pathologe 33, 316–323 (2012). https://doi.org/10.1007/s00292-012-1580-1

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