Diagnostic methods of R-S cells

Blood: The blood picture changes earlier, often accompanied by mild and moderate anemia, occasionally positive anti-human globulin test, a few white blood cells slightly or significantly increased, accompanied by neutropenia. About 1/5 patients have eosinophilia. Advanced lymphopenia. When the bone marrow is widely infiltrated or the spleen is hyperactive, pancytopenia may occur. In the active stage of the disease, the erythrocyte sedimentation rate, serum lactate dehydrogenase activity, α globulin, haptoglobin and plasma ceruloplasmin increased. When the activity of serum alkaline phosphatase or serum calcium increases, it means that bones are involved.

Bone marrow: mostly nonspecific. If Riesling cells can be found, it will be helpful for diagnosis. Riesling cells vary in size, about 20μm-60μm, and most of them are large and extremely irregular in shape. The cytoplasm is dichromatic, and the nucleus is irregular, which can be mirror-shaped, multi-leaf or multi-nuclear, and occasionally mononuclear, and the nucleoli can reach 1/3 of the nuclear size. In tuberous sclerosis HD, there seems to be a gap between the two nuclei due to deformation and plasma concentration, which is called lacunar Riesling cells. Infiltration is mostly transmitted by blood, and the positive rate of bone marrow puncture smear is only 3%, but biopsy can be improved to 9%~22%, which is of great significance to explore bone marrow metastasis.

Chest and mediastinal X-ray film: Hilar lymph node enlargement and pulmonary infiltration can be found.

Inferior vena cava angiography and intravenous pyelography: the former can find swollen lymph nodes near the aorta above the second lumbar vertebra, and the latter can show whether the ureter is displaced. In addition, when doing abdominal radiotherapy, you should know the location of the kidney.

Foot lymphangiography: Enlargement of lymph nodes in abdominal cavity and paraaorta can be found early.