Malignant Solitary Fibrous Tumor Cytopathologic Findings and Differential Diagnosis
Malignant Solitary Fibrous Tumor Cytopathologic Findings and Differential Diagnosis
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DOI：
10.1002/cncy.20069
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发表时间：
2010-04-25
影响因子：
3.4
通讯作者：
Ali, Syed Z.
中科院分区：
文献类型：
--
作者：
Bishop, Justin A.;Rekhtman, Natasha;Ali, Syed Z.
背景：恶性孤立性纤维肿瘤（SFT）是一种非常罕见的间叶肿瘤，且对其了解甚少。只有罕见的出版帐户的细胞病理学特征，这些肿瘤，促使目前的研究。设计：从3家大型教学医院的档案中检索1999年至2008年所有术前细针穿刺（FNAs）的恶性SFT病例。我们回顾了FNA涂片和细胞块材料，包括免疫过氧化物酶染色，并描述了细胞学特征。结果：11例患者中发现13例恶性SFT。平均年龄为58岁，男女比例为1：2.6。肿瘤一般较大，平均大小为13.4 cm。细胞形态学特征主要包括细胞过多的涂片，细胞呈单一的、丰满的梭形细胞组织碎片，细胞核末端钝，呈锯齿状，细胞质易碎，呈束状。还可见裸核，偶见有丝分裂和罕见坏死。一些病例显示上皮样细胞占优势，而另一些则显示松散的粘液瘤样基质。普遍缺乏单细胞。FNA无一例准确诊断为恶性SFT，仅6例诊断为恶性或可疑恶性。结论：恶性SFT的FNA诊断非常困难，需要组织学材料进行准确解释。主要FNA诊断为SFT或梭形细胞肿瘤。任何解剖部位的梭形细胞肿瘤的鉴别诊断必须包括恶性SFT，特别是如果它显示出良性SFT不典型的特征。免疫过氧化物酶染色具有一定的实用性，主要用于鉴别诊断中排除其他肿瘤。癌症（癌症细胞病理学）2010;118：83-9。(C)2070美国癌症协会
BACKGROUND: Malignant solitary fibrous tumors (SFTs) are extremely uncommon and poorly understood mesenchymal neoplasms. There are only rare published accounts of the cytopathologic features of these tumors, prompting the current study. DESIGN: All cases of malignant SFT with preoperative fine-needle aspirations (FNAs) from 1999 to 2008 were retrieved from the archives of 3 large teaching hospitals. FNA smears and cell block material including immunoperoxidase stains were reviewed, and the cytologic characteristics were described. RESULTS: Thirteen cases of malignant SFT were identified in 11 patients. Mean age was 58 years, with a men:women ratio of 1:2.6. The tumors were generally large, with a mean size of 13.4 cm. Cytomorphologic features included mostly hypercellular smears with tissue fragments of monotonous, plump spindled cells with blunt-ended and indented nuclei and fragile, wispy cytoplasm. Also seen were bare nuclei, occasional mitoses, and rare necrosis. Some cases showed a predominance of epithelioid cells, whereas others displayed a loose myxomatous matrix. There was a general lack of single cells. None of the cases was diagnosed accurately as malignant SFT on FNA, and only 6 cases were called malignant or suspicious for malignancy. CONCLUSIONS: The FNA diagnosis of malignant SFT is extremely difficult and needs histologic material for accurate interpretation. Predominant FNA diagnoses were SFT or spindle cell neoplasm. Malignant SFT must be included in the differential diagnosis of a spindle cell neoplasm of any anatomic site, particularly if it displays features not typical of benign SFT. Immunoperoxidase staining has some utility, mainly in ruling out other neoplasms in the differential diagnosis. Cancer (Cancer Cytopathol) 2010;118:83-9. (C) 2070 American Cancer Society