胸腔肿物穿刺细胞学误诊病例分析

Transthoracic Fine Needle Aspiration.An Analysis of Misdiagnosed Cases

我院于1980-1986年,胸腔穿刺578例,其中238例有组织学对照。细胞学诊断假阳性7例,假阴性3例及20例分型错误。本文指出引起假阳性诊断的主要原因是:1.涂片中细胞量少;2.细胞退变;3.反应性组织细胞易与恶性细胞相混淆;4.不典型增生的柱状细胞难与类癌和高分化腺癌鉴别。引起假阴性诊断的原因是:1.未将组织学标准与细胞学诊断结合,2.漏诊。并对引起分型错误的原因加以讨论。

Bewteen 1980 and 1986, a total of 578 transthoracic fine needle aspirations were performed. Of the 238 cases which were histologically confirmed cytologic diagnosis was incorrect in 30 i.e. false positive in 7, false negative in 3 and incorrectly typed in 20 False positivity might be attributed to (1) too little aspirated materials for evaluation;(2) degeneration of cells; (3) confusion by reactive histocytes; and (4) difficulty in differentiating hyperplastic columnar cells from carcinoid or well-differentiated adenocarcinoma. The causes that account for false negative diagnosis are (1) negligence of the histologic criteria; (2) misdiagnosis.Causes of incorrect classification are discussed as well.