[Cytological analysis of lymphoblastic lymphoma/acute lymphoblastic leukemia in serous effusion].

Objective: To study the diagnostic clues and significance in serous effusion cytology associated with lymphoblatic lymphoma/acute lymphoblastic leukemia (LBL/ALL). Methods: Forty-five serous effusion specimens with final diagnosis of LBL/ALL were collected from August 2011 to December 2019 at the First Affiliated Hospital of Zhengzhou University. All cases were reviewed for their clinical profiles, cytomorphologic features and ancillary studies. Cell blocks and immunocytochemistry were prepared in 22 cases; flow cytometric immunophenotyping was performed in three cases and gene rearrangement analysis (T-cell recepter, TCR and immunoglobulin, Ig) was performed in five cases. Results: Among the 45 cases, there were 35 males and 10 females with male to female ratio of 3.5∶1.0. The median age was 15 years. Mediastinal mass was the initial presentation in 39 patients (86.7%) and high LDL level were observed in 34 patients (75.6%). Microscopically, the majority of the specimens (86.7%) were hypercellular. The smears demonstrated dispersed lymphoblasts that were predominantly small to intermediate in size with scanty basophilic cytoplasm and irregular or convoluted nuclei with fine chromatin condensation and inconspicuous nucleoli. Mitoses were frequently observed. Karyorrhexis and apoptosis were seen in all cases. By immunophenotyping, TdT was expressed in 19 cases (86.4%) and CD99 in 20 cases (90.9%). Ki-67 expression varied from 65% to 95%. Flow cytometry in three cases demonstrated positivity for TdT, CD2, CD3 and CD7. Monoclonal TCR gene rearrangement was found in 4 of 5 cases, and both monoclonal TCR and Igκ gene were found in 1 case. Conclusions: In LBL/ALL, primary diagnosis could be made basing on clinical features (younger male patients with a mediastinum mass) and cytomorphology (monotonous, small to medium sized lymphoid cells with prominent irregular nuclei, fine chromatin and frequent mitoses, karyorrhexis and apoptosis). If immunocytochemistry and other ancillary studies are performed, the accuracy and reliability of the results could be improved.

[Investigation and analysis on occupational hazard factors exposure to the female workers in Gansu province].

Objective: To investigation on the occupational hazardous factors exposed to the female workers, from 14 prefectures and municipalities in Gansu province. Methods: The survey was conducted from June to October 2015. A total of 8 538 female employees from 30 enterprises in 14 prefectures and cities of the province were selected by cluster sampling method. The occupational hazard factors were investigated and analyzed statistically. Results: The survey found that the proportion of female workers in Gansu province who are exposed to chemical and physical harmful factors at the same time is relatively large. Most female workers are exposed to 2-4 occupational hazards, and women who are exposed to 3 and 4 chemical harmful factors account for 28.8 % and 38.0 %, respectively. Women workers who were exposed to two or three physical factors at the same time accounted for 59.44 per cent, while 61.5% were exposed to two biological factors at the same time. The number of female workers exposed to two or three physical factors at the same time and the number of four and five physical factors at the same time after being tested by χ(2). The difference is statistically significant (χ(2)= 8.17, P<0.05) . The difference in the number of female workers who simultaneously exposed 3 and 4 chemical factors and simultaneously exposed 2 and 5 or more chemical factors is statistically significant (χ(2)=11.26, P<0.05) . There was no significant difference in the exposure of female workers to biological factors. Conclusion: This survey shows that the exposure of female workers in Gansu Province to occupational hazards is not optimistic. We should strengthen enterprise supervision and improve the working environment and conditions of female workers.