假肉瘤性软组织病变的细针吸取细胞学

Fine needle aspiration cytology of pseudosarcomatous soft tissue lesions

目的 :总结假肉瘤性软组织病变细针吸取细胞学 (FNAC)特点 ,寻求在针吸细胞学基础上与肉瘤鉴别的要点。方法 :总结 10例结节性筋膜炎 ,1例增生性筋膜炎 ,1例增生性肌炎的针吸细胞学改变及临床经过。结果 :假肉瘤性软组织病变的FNAC特点是细胞的种类、形态、大小较多样化及多数会出现节细胞样细胞。细胞核大 ,核仁明显 ,但核的恶性特征不明显。有 6例结节性筋膜炎及 1例增生性肌炎临床自行消退。结论 :可凭FNAC特点将假肉瘤性病变与真正肉瘤鉴别 ,经FNAC诊为假肉瘤性病变者可建议临床观察 ,待病变自行消退 。

Purpose To sum up the fine needle aspiration cytology (FNAC) features of pseudosarcomatous soft tissue lesions and to estabilish the criteria in differentiating these lesions from true sarcoma. Methods To review the FNAC features and clinical courses of 10 cases of nodular fasciitis,1 case of proliferative fasciitis and 1 case of proliferative myositis. Results The FNAC features of the pseudosarcomatous soft tissue lesions were characterized by the pleomorphic pattern of the proliferative cells and the presence of ganglioncell like cells. In spite of the large nuclei and prominent nucleoli in some cells, the nuclei were cytologically benign. Six cases of nodular fasciitis and 1 case of proliferative myositis showed spontaneous resolution following diagnosis by FNAC. Conclusion It is possible to differentiate the pseudosarcomatous lesions from true sarcoma on the base of FNAC features. All pseudosarcomatous lesions diagnosed by FNAC should be managed nonsurgically first.