Liu K, Madden J F, Olatidoye B A, Dodd L G
Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Acta Cytol. 1999 Jul-Aug;43(4):552-7. doi: 10.1159/000331146.
To describe the cytomorphologic features of benign granular cell tumor (GCT) on fine needle aspiration (FNA) biopsy and discuss the differential diagnosis.
We reviewed three fine needle aspirates of surgically confirmed benign GCT. Immunocytochemical staining for S-100 was performed on the aspirate smear in one case.
Two GCT were thigh lesions, where lipoma and fibromatosis were the leading clinical diagnosis, and the third was a breast mass clinically suspected to be a fibroadenoma. All FNA specimens were highly cellular and composed of fairly uniform cells with eccentric, round-to-slightly oval nuclei and abundant, finely granular cytoplasm. The cells were fragile, with stripped nuclei in a background of finely granular material. Occasional cells with nuclear pleomorphism and small-but-conspicuous nucleoli were identified. There was no evidence of necrosis or mitotic activity. Rare intranuclear cytoplasmic inclusions were identified in two cases. The granular cells were immunoreactive for S-100 in the case studied.
Benign GCT has a distinctive cytomorphologic appearance that permits its diagnosis on FNA. High cellularity, occasional cells with nuclear pleomorphism and prominent nucleoli are features that can be present in benign GCT. Mitotic figures and necrosis should be identified before a diagnosis of malignancy is rendered.
描述细针穿刺活检(FNA)中良性颗粒细胞瘤(GCT)的细胞形态学特征并讨论鉴别诊断。
我们回顾了3例经手术证实的良性GCT的细针穿刺样本。其中1例对穿刺涂片进行了S-100免疫细胞化学染色。
2例GCT位于大腿,临床主要诊断为脂肪瘤和纤维瘤病,第3例是乳腺肿块,临床怀疑为纤维腺瘤。所有FNA标本细胞丰富,由相当均匀的细胞组成,细胞核偏心、圆形至略呈椭圆形,细胞质丰富、细颗粒状。细胞易碎,在细颗粒物质背景中有裸核。偶见细胞核异形性和小而明显核仁的细胞。无坏死或有丝分裂活性的证据。2例中发现罕见的核内胞质包涵体。在所研究的病例中,颗粒细胞对S-100呈免疫反应性。
良性GCT具有独特的细胞形态学表现,可通过FNA进行诊断。细胞丰富、偶见细胞核异形性和明显核仁是良性GCT可能出现的特征。在做出恶性诊断之前应识别有丝分裂象和坏死。