恶性PEComa伴腹水转移细胞学形态总结并文献复习

Malignant PEComa metastasis with ascites: cytological analyses and review of literature

目的探讨恶性具有血管周上皮样细胞分化的肿瘤(PEComa)在浆膜腔积液中的细胞学形态,旨在提高对PEComa的细胞学特征认识及鉴别诊断。方法通过对1例恶性PEComa转移至腹水病例的细胞涂片、细胞块、组织块和免疫组化特征进行描述及分析比对,讨论和综述其细胞学特征并复习相关文献。结果细胞涂片及细胞块切片内见中等量细胞,散在或小团簇排列,细胞呈上皮样,核圆形,居中或偏位,部分可见核仁;细胞质空泡状或致密,细胞边界清楚;可见裸核。细胞块免疫组化HMB45(+)。结论结合临床病史、形态及细胞块免疫组化,浆膜腔积液中的恶性PEComa转移可以被明确诊断。

Objective To investigate the morphologic features of perivascular epithelioid cell tumour(PEComa) in the fluid of serous cavity and to recognize its cytologic characteristics and differential diagnosis. Methods Findings of smear, cell block, tissue block and immunostains were retrospectively reviewed. Cytologic features were discussed and summarized, with review of literatures. Results Moderate amount of cells were detected in smear and cell block, forming scattered or small clusters. Those cells were epithelioid, with round centric or eccentric nuclei. The cytoplasm was vesicular or dense, with sharp borders. Scattered bare nuclei were noted. Immunostain of HMB45 was positive on cell block. Conclusion Based on the clinical history, morphology and immunostains on cell block, diagnosis of metastatic malignant PEComa in the fluid of serous cavity can be confirmed.