假肉瘤性軟組織病變的細針吸取細胞學

Fine Needle Aspiration Cytology of Pseudosarcomatous Soft Tissue Lesions

目的:總結假肉瘤性軟組織病變細針吸取細胞學(FNAC)特點.尋求在針吸細胞學基礎上與肉瘤鑑別.方法:總結10例結節性筋膜炎,1例增生性筋膜炎,1例增生性肌炎的針吸細胞學改變及臨床經過。結果:假肉瘤性軟組織病變的FNAC特點是細胞的種類,形態,大小較多樣化及多數會出現節細胞樣細胞.細胞核大,核仁明顯,但核的惡性特征不明顯.有6例結節性筋膜炎及1例增生性肌炎臨床自行消退.結論:可憑FNAC特點將假肉瘤性病變與真正肉瘤鑑別.經FNAC診爲假肉瘤性病變者可建議臨床觀察,待病變消退而無需進行不必要的切除術.

Objective:To sum up the fine needle aspiration cytology(FNAC)features of pseudosarcomatous soft tissue lesions and to establish 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 are characterized by the pleomorphic pattern of the proliferative cells and the presence of ganglioncelllike cells.In spite of the large nuclei and prominent nucleoli in some cells,the nuclei are 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.