MacDonald L L, Yazdi H M
Division of Anatomical Pathology, Department of Laboratory Medicine, The Ottawa Hospital-Civic Campus, Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Cancer. 2001 Feb 25;93(1):29-34.
The purpose of the current study was to determine the accuracy of the cytologic diagnosis of bronchioloalveolar carcinoma (BAC) by fine-needle aspiration biopsy (FNAB).
During a 4-year period (1994-1998), 1664 lung FNABs were performed. Forty-nine patients with BAC diagnosed by FNAB and/or surgical biopsy formed the basis of this study.
Twenty-four patients diagnosed with BAC by FNAB had histologic confirmation. Surgical pathology revealed BAC in 15 patients with a cytologic diagnosis of large cell carcinoma (LCA) or adenocarcinoma (ACA). Nine patients diagnosed with BAC by FNAB were found to have ACA histologically. One unsatisfactory aspirate was diagnosed as BAC by surgical pathology. Review of 15 FNAB specimens with a diagnosis of LCA or ACA revealed cytologic features typical of BAC. In six aspirates, additional features such as pronounced nuclear crowding and overlapping, variation in nuclear size, and increased number of pleomorphic cells interfered with the FNAB diagnosis of BAC. Nine FNABs with a diagnosis of BAC were found histologically to have ACA with a focal BAC growth pattern. One unsatisfactory FNAB aspirate diagnosed as BAC histologically was due to sampling error.
A diagnosis of BAC by FNAB is possible using conventional cytologic criteria. Some BACs show pronounced nuclear crowding and overlapping, variation in nuclear size, and an increased number of pleomorphic cells cytologically, which may interfere with an FNAB diagnosis of BAC. FNABs from ACA cases with a focal BAC pattern remain a diagnostic dilemma due to the nature of the lesion. In addition, sampling error by FNAB can be a diagnostic pitfall. Cancer (Cancer Cytopathol)
本研究的目的是确定细针穿刺活检（FNAB）对细支气管肺泡癌（BAC）进行细胞学诊断的准确性。
在4年期间（1994 - 1998年），共进行了1664例肺FNAB。49例经FNAB和/或手术活检诊断为BAC的患者构成了本研究的基础。
24例经FNAB诊断为BAC的患者获得了组织学证实。手术病理显示，15例细胞学诊断为大细胞癌（LCA）或腺癌（ACA）的患者实际上为BAC。9例经FNAB诊断为BAC的患者组织学检查为ACA。1例不满意的穿刺标本经手术病理诊断为BAC。对15例诊断为LCA或ACA的FNAB标本进行复查，发现具有BAC的典型细胞学特征。在6例穿刺物中，其他特征如明显的核拥挤和重叠、核大小变异以及多形性细胞数量增加，干扰了FNAB对BAC的诊断。9例诊断为BAC的FNAB组织学检查显示为具有局灶性BAC生长模式的ACA。1例经组织学诊断为BAC的不满意FNAB穿刺物是由于采样误差所致。
使用传统细胞学标准通过FNAB诊断BAC是可行的。一些BAC在细胞学上表现出明显的核拥挤和重叠、核大小变异以及多形性细胞数量增加，这可能会干扰FNAB对BAC的诊断。由于病变的性质，具有局灶性BAC模式的ACA病例的FNAB仍然是一个诊断难题。此外，FNAB的采样误差可能是一个诊断陷阱。癌症（癌症细胞病理学）
