颈部神经鞘瘤的细针穿刺细胞学诊断(附90例组织病理学对照)

THE CYTOLOGIC DIAGNOSIS OF FINE NEEDLE ASPIRATION FOR THE SCHWANNOMA IN THE NECK(AN ANALYSIS OF 90 CASES FOR COMPARATIVE HISTOPATHOLOGY)

目的 总结近十年期间该院的神经鞘瘤患者９０ 例细胞学诊断的体会及经验。 方法 应用细针穿刺涂片，ＨＥ染色，光镜观察，并与组织病理学诊断相对照。 结果 手术前穿刺细胞学诊断或提示为神经鞘瘤者５５例占６１－１２％ ；诊断为软组织良性肿瘤或良性病变者２０ 例占２２－２２％ ；漏诊１１ 例占１２－２２％ ；误诊４ 例占４－４４％ 。 结论 来自颅神经的神经鞘瘤由于在穿刺时其放射性酸麻感不及来自臂丛神经的神经鞘瘤明显，故给细胞学诊断带来了一定的难度。造成漏诊的主要原因是未穿刺到具有诊断价值的肿瘤细胞。

PURPOSE In order to review and summarize our experience of 90 cases in fine needle aspiration cytology diagnosis of Schwannoma,confirmed during the last 10 years in this hospital.METHODS Fine needle aspiration and smear,HE staining,followed by optical microscopy,and comparison to the post surgical histopathology.RESULTS 55 cases (61.12%) were diagnosed or indicated as Schwannoma,20 cases(22.22%)were diagnosed as benign tumors of soft tissue origin or other benign lesions,11 cases(12.22%) were false negative and finally 4 cases (4.44%) were mis diagnosed as other diseases.CONCLUSIONS Schwannoma originated from cranial nerves are more difficult to diagnose with cytology technique,due to its less prominently radiated tingling or numb sensation during the needle aspiration process,compared to those originated from brachial plexus.the major cause of diagnosis failure was the inability to those tumor cells of diagnostic importance.It is also essential to differentiate schwannoma from the lymphnode metastasis of low grade squamous cell carcinoma