Exfoliative cytologic findings of primary pulmonary adenoid cystic carcinom: a report of 2 cases with a review of the cytologic features.
Exfoliative cytologic findings of primary pulmonary adenoid cystic carcinom: a report of 2 cases with a review of the cytologic features.
复制标题
原发性肺腺样囊性癌的剥脱细胞学表现：2例报告及细胞学特征回顾。
作者：
Y. Daneshbod;Ebrahim Modjtahedi;S. Atefi;G. Bedayat;K. Daneshbod
背景
腺样囊性癌是一种非常罕见的原发性肺部肿瘤。介绍了2例具有特殊组织学特征的原发性支气管腺样囊性癌的肺部冲洗和刷检的细胞学表现，重点介绍了一些以前未报道过的要点，以及诊断的误区。
案例
2例经脱落细胞学诊断为原发性肺腺样囊性癌。患者年龄分别为55岁和65岁。细胞学检查结果包括二维和三维空间中大小不一的小细胞簇，偶尔含有粘液物质的囊状空间。细胞排列成球形、圆柱形、基底样和玫瑰花状排列。还有丰富的大大小小的粘液球、均质的无细胞粘液物质圆柱体和“炮弹”。在案例 1 中注意到细胞质和核内圆形内含物。注意到罕见的核成型现象。在病例 2 中，软骨粘液样物质和双形肿瘤细胞群导致与其他唾液腺型肺部肿瘤的诊断混淆。
结论
这些病例表现出腺样囊性癌的特征性细胞学表现，以及罕见的细胞内和细胞外包涵体、粘软骨样物质、双形群体和核成型的发现，这可能导致与其他肺部肿瘤的诊断混淆。
BACKGROUND
Adenoid cystic carcinoma is a very rare primary pulmonary neoplasm. Cytologic findings of pulmonary washing and brushing in 2 cases of primary bronchial adenoid cystic carcinoma with special histologic features are described, with an emphasis on some points that have not been reported previously, together with the diagnostic pitfalls.
CASES
Two cases of primary adenoid cystic carcinoma of the lung were diagnosed on exfoliative cytology. The patients' ages were 55 and 65 years old. Cytologic findings included large and small clusters of small cells in both 2 and 3 dimensions with occasional cystlike spaces containing mucoid material. The cells were arranged in spherical, cylindrical, basaloid and rosettelike arrangements. There were also abundant small and large mucoid globules, cylinders of homogeneous, acellular, mucous material and "cannon balls." Cytoplasmic and intranuclear round inclusions were noted in case 1. Rare findings of nuclear molding were noted. In case 2, chondromyxoid material and a bimorphic population of tumor cells caused diagnostic confusion with other salivary gland-type tumors of the lung.
CONCLUSION
These cases showed characteristic cytologic findings of adenoid cystic carcinoma together with rare findings of intracellular and extracellular inclusionlike bodies, myxochondroid material, bimorphic populations and nuclear molding, which can cause diagnostic confusion with other lung tumors.