2005 Volume 44 Issue 3 Pages 118-123
Objective: We analyzed cytomorphological differential diagnosis between follicular lymphoma (FL) grade 1 and reactive follicular hyperplasia in Papanicolaou (Pap.) smears and the advantage of immunocytochemical analysis of bcl-2 for differentially diagnosing of FL grade 1 Study Design: Ten cases of reactive follicular hyperplasia and 20 cases of FL Grade 1 were screened by ×40 objective microscopy and identified with ×100 objective microscopy. The percentage of bcl-2 positive cells was also calculated.
Results: Screening showed that FL grade 1 showed 1) the high appearance of two-nuclei-like cleaved cells and 2) none or few tingible body macrophages compared to reactive follicular hyperplasia. Identification analysis showed that 1) approximately half of FL Grade 1 cases showed similar appearance of individual cells to those of reactive follicular hyperplasia and 2) nucleoli larger than one, μm and cleaved nuclei were high in number, and bcl-2 protein was highly positive in FL grade 1.
Conclusion: Cytomorphological differential diagnosis of FL grade 1 from reactive follicular hyperplasia is relatively difficult. We found that two-nuclei-like cleaved cells and nucleoli in small lymphocytes observed by ×40 objective microscopy were high in number in diagnosing of FL grade 1 in Pap smears.
