Crapanzano J P, Ali S Z, Ginsberg M S, Zakowski M F
Cytology Service, Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Cancer. 2001 Feb 25;93(1):40-51.
Chordoma is a rare malignant tumor of fetal notochord origin that occurs along the spinal axis. The fine-needle aspiration biopsy (FNAB) findings are described, correlated with histology and radiology, and compared with previously reported descriptions of chordoma.
Fine-needle aspiration biopsies of 12 cases of chordoma with histologic confirmation were reviewed. Imaging studies were reviewed in seven cases. Cytologic material included smears, ThinPrep, and cell blocks. Immunostains were performed on selected cytologic and histologic specimens. Multiple cytologic parameters were studied.
Eleven specimens were from the spinal axis, and one was from a chest wall metastasis. Ten cases were diagnosed as chordoma on cytologic material, one was positive for malignancy with a differential diagnosis of chordoma and well differentiated chondrosarcoma, and one was positive for malignancy, not further classified. Most smears were moderately to highly cellular and demonstrated typical physaliphorous cells and a myxoid background. Two of the 10 cases diagnosed as chordoma showed pleomorphic physaliphorous cells, nuclear inclusions, and binucleation. Nuclear inclusions were observed in three other cases diagnosed as chordoma. Histologic follow-up of one case with pleomorphic physaliphorous cells showed conventional chordoma with focal areas of increased cellularity and pleomorphism. Pleomorphic sarcomatous cells were the predominant cell type in one case that showed dedifferentiated chordoma histologically. Mitotic figures were rarely observed in cytologic material.
Cytomorphologic features of chordoma allow accurate diagnosis by FNAB. Features associated with dedifferentiation include increased pleomorphism of physaliphorous cells and may include nuclear inclusions, bi- or multinucleation, and rarely, mitotic figures. Cancer (Cancer Cytopathol)
脊索瘤是一种起源于胎儿脊索的罕见恶性肿瘤，沿脊柱轴发生。本文描述了细针穿刺活检（FNAB）的结果，将其与组织学和放射学结果相关联，并与先前报道的脊索瘤描述进行比较。
回顾性分析12例经组织学证实的脊索瘤细针穿刺活检病例。对其中7例进行了影像学检查回顾。细胞学材料包括涂片、液基薄层制片和细胞块。对选定的细胞学和组织学标本进行免疫染色。研究了多个细胞学参数。
11个标本来自脊柱轴，1个来自胸壁转移灶。10例经细胞学材料诊断为脊索瘤，1例恶性诊断阳性，鉴别诊断为脊索瘤和高分化软骨肉瘤，1例恶性诊断阳性，未进一步分类。大多数涂片细胞中度至高度丰富，可见典型的空泡状细胞和黏液样背景。10例诊断为脊索瘤的病例中有2例显示多形性空泡状细胞、核内包涵体和双核。在另外3例诊断为脊索瘤的病例中观察到核内包涵体。1例有多形性空泡状细胞的病例组织学随访显示为传统脊索瘤，局部细胞增多和多形性区域。1例组织学显示去分化脊索瘤的病例中，多形性肉瘤样细胞是主要细胞类型。在细胞学材料中很少观察到有丝分裂象。
脊索瘤的细胞形态学特征可通过FNAB进行准确诊断。与去分化相关的特征包括空泡状细胞多形性增加，可能包括核内包涵体、双核或多核，以及罕见的有丝分裂象。《癌症（癌症细胞病理学）》
