Abstract：
BACKGROUND: The occurrence of extragonadal germ cell tumors (EGGCTs), either as primary tumors or metastatic disease, is rare. Forms of cytologic sampling, including fluid analysis, fine-needle aspiration, and/or small-core needle biopsy, have been shown to be reliable methods for the diagnosis of germ cell tumors. This study aims to investigate the utility of cytopathologic techniques in the diagnosis of EGGCTs at the authors\' institution.
METHODS: The laboratory information system was queried over a period of 10 years (2012-2022) to identify all cytology cases diagnosed on fluid cytology, FNA, and/or small-core biopsy as germ cell tumors in extragonadal locations. Patient demographics, tumor location, serum tumor marker levels, cytopathologic diagnosis, and follow-up surgical resection data were reviewed and correlated.
RESULTS: A total of 35 cases from 32 patients (all males) were identified. Thirty specimens contained satisfactory material for diagnosis (86%) and five were less than optimal for evaluation (14%). Despite this, all cases had clinically useful cytopathologic diagnoses. A total of 19 cytology cases (16 patients) had follow-up resection specimens available. Of these, 11 patients underwent preoperative chemotherapy. Nine patients showed no evidence of residual tumor and two showed histologic concordance. Of the five patients who did not have preoperative chemotherapy, all showed concordant histologic diagnoses.
CONCLUSIONS: Cytology can provide a reliable, accurate method for diagnosing EGGCTs. The practice of preoperative (neoadjuvant) chemotherapy places an extreme importance on the initial cytopathologic diagnosis because the majority of patients with follow-up resection in this series showed no residual tumor.
METHODS: The laboratory information system was queried over a period of 10 years (2012-2022) to identify all cytology cases diagnosed on fluid cytology, FNA, and/or small-core biopsy as germ cell tumors in extragonadal locations. Patient demographics, tumor location, serum tumor marker levels, cytopathologic diagnosis, and follow-up surgical resection data were reviewed and correlated.
RESULTS: A total of 35 cases from 32 patients (all males) were identified. Thirty specimens contained satisfactory material for diagnosis (86%) and five were less than optimal for evaluation (14%). Despite this, all cases had clinically useful cytopathologic diagnoses. A total of 19 cytology cases (16 patients) had follow-up resection specimens available. Of these, 11 patients underwent preoperative chemotherapy. Nine patients showed no evidence of residual tumor and two showed histologic concordance. Of the five patients who did not have preoperative chemotherapy, all showed concordant histologic diagnoses.
CONCLUSIONS: Cytology can provide a reliable, accurate method for diagnosing EGGCTs. The practice of preoperative (neoadjuvant) chemotherapy places an extreme importance on the initial cytopathologic diagnosis because the majority of patients with follow-up resection in this series showed no residual tumor.
摘要：
背景：性腺外生殖细胞肿瘤（EGGCT）的发生，无论是原发性肿瘤还是转移性疾病，是罕见的。细胞学取样的形式，包括流体分析，细针抽吸,和/或小芯针活检，已被证明是诊断生殖细胞肿瘤的可靠方法。本研究旨在探讨细胞病理学技术在作者机构EGGCT诊断中的应用。
方法：对实验室信息系统进行了10年（2012-2022年）的查询，以识别所有通过液体细胞学诊断的细胞学病例，FNA,和/或小核心活检为性腺外位置的生殖细胞肿瘤。患者人口统计学，肿瘤位置,血清肿瘤标志物水平，细胞病理学诊断，和随访的手术切除数据进行回顾和关联。
结果：从32例患者（均为男性）中确定了35例。30个样本包含令人满意的诊断材料（86％），而5个样本的评估效果低于最佳（14％）。尽管如此,所有病例均有临床有用的细胞病理学诊断.共有19例细胞学病例（16例患者）获得了随访切除标本。其中,11例患者均行术前化疗。9例患者没有显示残留肿瘤的证据，2例显示组织学一致性。在五名没有接受术前化疗的患者中，均显示一致的组织学诊断.
结论：细胞学可以提供可靠的，诊断EGGCT的准确方法。术前（新辅助）化疗的实践对最初的细胞病理学诊断极为重要，因为该系列中大多数进行随访切除的患者均未显示残留肿瘤。
方法：对实验室信息系统进行了10年（2012-2022年）的查询，以识别所有通过液体细胞学诊断的细胞学病例，FNA,和/或小核心活检为性腺外位置的生殖细胞肿瘤。患者人口统计学，肿瘤位置,血清肿瘤标志物水平，细胞病理学诊断，和随访的手术切除数据进行回顾和关联。
结果：从32例患者（均为男性）中确定了35例。30个样本包含令人满意的诊断材料（86％），而5个样本的评估效果低于最佳（14％）。尽管如此,所有病例均有临床有用的细胞病理学诊断.共有19例细胞学病例（16例患者）获得了随访切除标本。其中,11例患者均行术前化疗。9例患者没有显示残留肿瘤的证据，2例显示组织学一致性。在五名没有接受术前化疗的患者中，均显示一致的组织学诊断.
结论：细胞学可以提供可靠的，诊断EGGCT的准确方法。术前（新辅助）化疗的实践对最初的细胞病理学诊断极为重要，因为该系列中大多数进行随访切除的患者均未显示残留肿瘤。
