背景:气管支气管树原发性腺样囊性癌(AdCC)非常罕见,具有很高的复发和转移风险。通过组织学和免疫组织化学手段对AdCC的诊断已经在临床上得到了很好的研究。然而,由于癌症呈现的非典型特征,因此通过细胞学特征鉴定AdCC仍然难以捉摸.本研究旨在通过支气管刷检描述AdCC的细胞学特征,这有助于将AdCC与其他肺癌区分开来。
方法:7例支气管刷检涂片的细胞病理学特征经组织学诊断为AdCC。确定的细胞学特征,这可能是诊断,进行了系统分析。
结果:7例细胞学病例中有4例与组织学诊断不一致,细胞学分类为恶性细胞阳性,小细胞癌,或非典型细胞。3例表现为特征性的腺样体结构和洋红色基质形成小球,这与这四种情况不同。细胞学上,上述3例均匀,细胞核相对较小,细胞质很少。在这项研究中,仅1例显示非典型多边形中型细胞,核仁明显。
结论:与细针穿刺细胞学不同,品红色基质球可能为临床上的AdCC细胞诊断提供替代线索。支气管刷洗细胞学检查更多存在于具有高核质比和背景粘液物质的平淡均匀细胞中。应收集更多病例并通过组织病理学检查进行确认,并仔细阅读电影以减少误诊率。
BACKGROUND: Primary adenoid cystic carcinoma (AdCC) of the tracheobronchial tree is very rare with a high risk for recurrence and metastasis. The diagnosis of AdCC by histologic and immunohistochemical means has been well studied clinically. However, the identification of AdCC by cytologic features remains elusive due to the atypical features the cancer presents. This study aimed to describe the cytologic features of AdCC by using bronchial brushing, which could aid in distinguishing AdCC from other pulmonary carcinomas.
METHODS: The cytopathological features of bronchial brushing smears collected from seven cases were histologically diagnosed as AdCC. The defined cytologic features, which could potentially be diagnostic, were systemically analyzed.
RESULTS: Four out of the seven cytologic cases were inconcordance with the histologic diagnosis and cytologically classified as positive for malignant cells, small cell carcinoma, or atypical cells. Three cases showed a characteristic adenoid structure and magenta stroma forming globule, which was distinguished from the four cases. Cytologically, the above mentioned three cases were uniform with relatively small bland nuclei and little cytoplasm. In this study, only one
case showed atypical polygonal medium-sized cells with conspicuous nucleoli.
CONCLUSIONS: Unlike fine-needle aspiration cytology, magenta stroma globules might offer an alternate clue for cytodiagnosis of AdCC clinically. Bronchial brushings cytology was more present in bland uniform cells with high nuclear to cytoplasmic ratios and background mucoid substance. More cases should be collected and confirmed using histopathology with careful film reading to reduce the rate of misdiagnosis.