Aspiration cytology of the spleen in hematologic disorders
Chong, L.L.; Wang, Y.C.; Hsueh, S.C.
Journal of the Formosan Medical Association 84(12): 1323-1333
1985
ISSN/ISBN: 0371-7682 PMID: 3869638 Document Number: 244885
One hundred and five fine needle aspiration cytologies of the spleen from patients suffering from various hematologic disorders were studied. Most patients (67%) were with palpable spleen. Imprinted spleen smears obtained from 3 splenectomized specimens that proved normal histologically were used as a control splenocytogram. Using Wright's stain, only 7 failed to obtain the splenic elements (failure rate 6.7%). The results showed: Splenic erythroid hyperplasia (5-52% erythroblasts) in 3 of 5 autoimmune hemolytic anemia, 3 of 5 congenital hemolytic anemia, 4 myelofibrosis, 1 chronic myelocytic leukemia (CML) and 1 malignant lymphoma; myeloid metaplasia (myeloid cells 26-90%, erythroblasts 3-15%) in 23 of 25 CML, 5 myelofibrosis, 1 of 2 polycythemia vera; lymhocytosis with poorly differentiated cells in 8 of 12 lymphomas, well differentiated cells in 2 chronic lymphocytic leukemia; plasmacytosis in all 4 multiple myeloma; blastosis in all 2 CML with acute blastic transformation. Reed-Sternberg cells were found in 1 of 3 Hodgkin's disease. Carcinoma cells were found in 2 of 6 patients clinically suspected or proved as nonhematologic malignancies. Normal splenocytogram was noted in 3 idiopathic thrombocytoenic purpura, 5 anemia or biocytopenia with/without hepatosplenomegaly, and 1 CML. The most remarkable side effect was the transient local pain. It is an easy, safe and rapid diagnostic procedure in experienced hands with a rather high degree of preference value in certain aspects of clinical practice.