Liu K, Dodge R K, Dodd L G, Layfield L J
Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA.
Acta Cytol. 1999 Mar-Apr;43(2):143-52. doi: 10.1159/000330968.
To identify key diagnostic cytologic criteria for various low grade spindle cell lesions.
We reviewed 20 synovial sarcomas, 18 benign neural tumors, 10 reparative lesions, 24 other benign and 27 additional malignant low grade spindle cell lesions. All specimens were coded as to the presence or absence of the following variables: high cellularity, tissue fragments, tissue culture appearance, epithelial fragments, vessel fragments, vascular arcades, fibrillar ground substance, myxoid background, microcystic areas, parallel arrangement of nuclei, naked nuclei, single cells, binucleate cells, multinucleate cells, long filamentous cells, short spindle cells, stellate cells, lipoblasts, nuclear pleomorphism, nuclei with pointed ends, comma/fishhook nuclei, cigar-shaped nuclei, ovoid/round nuclei, small nucleoli, large nucleoli, mitotic figures, intranuclear vacuoles and background histiocytes. A logistic regression analysis was performed to identify the variables predictive of malignant lesions, specifically synovial sarcomas, benign neural tumors and reparative lesions.
Statistical analysis selected high cellularity, short spindle cells, small nucleoli and absence of tissue culture appearance as the main criteria for malignant neoplasms. Tissue fragments and high cellularity were selected as the primary criteria and absence of long filamentous cells and of myxoid background as the secondary criteria for synovial sarcomas. It selected fibrillar ground substance and absence of ovoid/round nuclei as the key criteria for benign neural tumors. The presence of a tissue culture appearance was the major criterion for reparative lesions.
There are many previously described cytologic criteria, but we found that when subjected to statistical analysis, only a few features were significant in the evaluation of low grade spindle cell lesions.
确定各种低级别梭形细胞病变的关键诊断细胞学标准。
我们回顾了20例滑膜肉瘤、18例良性神经肿瘤、10例修复性病变、24例其他良性和27例额外的恶性低级别梭形细胞病变。所有标本根据以下变量的有无进行编码：高细胞密度、组织碎片、组织培养外观、上皮碎片、血管碎片、血管拱廊、纤维状基质、黏液样背景、微囊区域、核平行排列、裸核、单细胞、双核细胞、多核细胞、长丝状细胞、短梭形细胞、星状细胞、脂肪母细胞、核异型性、尖端核、逗号/鱼钩状核、雪茄形核、卵圆形/圆形核、小核仁、大核仁、有丝分裂象、核内空泡和背景组织细胞。进行逻辑回归分析以确定预测恶性病变（特别是滑膜肉瘤、良性神经肿瘤和修复性病变）的变量。
统计分析选择高细胞密度、短梭形细胞、小核仁以及无组织培养外观作为恶性肿瘤的主要标准。组织碎片和高细胞密度被选为滑膜肉瘤的主要标准，无长丝状细胞和黏液样背景被选为次要标准。它选择纤维状基质和无卵圆形/圆形核作为良性神经肿瘤的关键标准。有组织培养外观是修复性病变的主要标准。
有许多先前描述的细胞学标准，但我们发现，经过统计分析后，在评估低级别梭形细胞病变时只有少数特征具有显著性。
