摘要
目的总结各软组织黏液性病变的细针吸取细胞学(FNAC)特点,确定鉴别良恶性病变和个别病变诊断的细胞学标准及其临床意义。方法总结1993-2006年澳门特别行政区镜湖医院24例软组织黏液性病变(良性病变14例,恶性病变10例)的针吸细胞学改变,结合临床资料经过及手术后结果进行综合分析。结果腱鞘囊肿(5例)、黏液瘤(5例)及黏液型结节性筋膜炎(3例)是最常见的良性软组织黏液性病变;共同的特点是涂片细胞较少,细胞无明显的不典型性。腱鞘囊肿的特点是吸出黏液后结节消失或明显缩小,涂片不见血管;黏液型结节性筋膜炎的特点是细胞多形性或有节细胞样细胞。黏液型脂肪肉瘤、骨外黏液型软骨肉瘤及黏液型纤维肉瘤是最常见的黏液型肉瘤,其共同的特点是涂片细胞丰富及细胞具有一定的不典型性。黏液型脂肪肉瘤的特点多有鸡爪样纤细的毛细血管或脂肪母细胞;黏液型纤维肉瘤的特点是细胞的多形性与异型性均非常明显。结论结合临床及辅助检查,FNAC 是诊断软组织黏液性病变的有效方法。在软组织病变中,FNAC可为软组织黏液性病变制订治疗计划提供了客观的根据,亦有助于避免某些不必要的切除手术。
Objective To summarize the diagnostic features of fine needle aspiration cytology （FNAC） of myxoid lesions in soft tissue, and to define the cytological criteria for differentiating benign lesions from sarcomas and between various myxoid lesions. Methods FNAC data of 24 soft tissue myxoid lesions （ 14 benign lesions, 10 malignant lesions） from 1993 to 2006 from Kiang Wu Hospital, Macao were reviewed in correlation with the clinical course or the results of biopsy. Results Ganglion, myxoma, and myxoid nodular fasciitis were the most common benign myxoid lesions of the soft tissues, all of which had low cellularity and lack of marked cellular atypia in smears in common. Ganglion was characterized by the disappearance of or the gradual minimization of the nodule after aspiration and the lack of blood vessel in smears. Myxoid nodular fasciitis was characterized by a pleomorphic pattern of proliferative cells and the presence of ganglion cell-like cells. Myxoid liposarcoma, extraskeletal myxoid chondrosarcoma and myxofibrosarcoma were the most common myxoid sarcomas. Cytologically, they had high cellularity and various degrees of cellular atypia. Myxoid liposarcoma exhibited branching chicken-wire like capillary vessels and/or lipoblasts; myxofibrosarcoma were prominent in both pleomorphic and atypia of the cells. The data revealed that the diagnostic accuracy of FNAC was nearly 100% in differentiating benign and malignant myxoid lesions of the soft tissues. The coordinate rate to the histopathology diagnosis of the common myxoid lesions of the soft tissues was above 75% （ benign 71.4% and malignancy 80% respectively）. Conclusions FNAC is an effective method in diagnosing myxoid lesions of soft tissue, in correlation with the clinical data and the accessory examinations. FNAC can provide an objective basis for the treatment of myxoid lesions and prevention of unnecessary surgical operations.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2007年第9期619-624,共6页
Chinese Journal of Pathology
关键词
软组织肿瘤
活组织检查
细针
细胞学
诊断
鉴别
Soft tissue neoplasms
Biopsy,fine-needle
Cytology
Diagnosis, differential
