Sadeghi S, Pitman M B, Weir M M
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
Diagn Cytopathol. 1999 Nov;21(5):340-5. doi: 10.1002/(sici)1097-0339(199911)21:5<340::aid-dc9>3.0.co;2-c.
The cytologic findings of two cases of metastatic sebaceous carcinoma are described and compared to three cases of locally recurrent basal cell carcinoma. Morphological findings for sebaceous carcinoma in fine-needle aspiration biopsy (FNAB) smears included cellular, loosely cohesive cell clusters with central necrosis, squamous pearl formation, and adjacent keratin debris. The tumor cells had moderate amounts of vacuolated cytoplasm, round to oval vesicular nuclei with clumped chromatin, nucleoli, some nuclear overlap, and numerous mitotic figures. An interesting finding was the presence of numerous multinucleated giant cells, probably responding to extravasated lipid or keratin material. In contrast, the FNAB smears of basal cell carcinoma typically were less cellular, with more tightly cohesive and smaller clusters of uniform hyperchromatic basaloid cells with high nuclear to cytoplasmic ratios, and a narrow rim of cytoplasm without vacuolization. The morphologic features of sebaceous carcinoma in FNAB smears appear to be distinct from those of basal cell carcinoma. FNAB can be a useful preoperative diagnostic technique to distinguish these two cutaneous malignancies.
本文描述了两例转移性皮脂腺癌的细胞学检查结果，并与三例局部复发性基底细胞癌进行了比较。细针穿刺活检（FNAB）涂片检查皮脂腺癌的形态学表现包括细胞成分、松散聚集的细胞团块伴中央坏死、鳞状上皮珠形成及相邻的角质碎屑。肿瘤细胞有中等量的空泡状胞质、圆形至椭圆形泡状核、染色质聚集、核仁、部分核重叠及大量有丝分裂象。一个有趣的发现是存在大量多核巨细胞，可能是对溢出的脂质或角质物质的反应。相比之下，基底细胞癌的FNAB涂片通常细胞成分较少，有更紧密聚集且较小的均匀深染基底样细胞团块，核质比高，细胞质边缘狭窄且无空泡化。FNAB涂片中皮脂腺癌的形态学特征似乎与基底细胞癌不同。FNAB可作为术前区分这两种皮肤恶性肿瘤的有用诊断技术。
