Cardillo M, Zakowski M F, Lin O
Department of Pathology, Cytology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Cancer. 2001 Aug 25;93(4):246-51. doi: 10.1002/cncr.9037.
Epithelioid sarcoma is a rare tumor with characteristic morphologic and immunohistochemical features. It can be confused histologically and cytologically with a variety of benign and malignant lesions, including a granulomatous process, synovial sarcoma, melanoma, squamous cell carcinoma, and adenocarcinoma. The objective of this study was to define the cytologic features of this rare tumor.
The cytologic features of nine histologically confirmed epithelioid sarcomas were analyzed. The criteria evaluated included cell size and shape, cell borders, cluster organization, cytoplasmic characteristics, nuclear and nucleolar features, and background characteristics.
In most cases, single, dispersed cells represented the predominant pattern, with only a few small clusters present. The cells were mostly round with interspersed spindle cells and mild to moderate pleomorphism. The nuclei were large and eccentrically located, with a plasmacytoid appearance. A pale zone in the perinuclear area was evident in three of nine cases. Well-defined cell borders with intercellular spaces between malignant cells were observed in eight cases. In three cases, a granuloma-like structure was identified. In two cases, the cells were mostly spindle and showed greater cellular pleomorphism.
Epithelioid sarcoma is an uncommon tumor with a wide range of differential diagnoses, especially in cytology specimens. Awareness of its existence and knowledge of its cytologic features are important for a correct diagnosis.
上皮样肉瘤是一种具有特征性形态学和免疫组化特征的罕见肿瘤。在组织学和细胞学上，它可与多种良性和恶性病变相混淆，包括肉芽肿性病变、滑膜肉瘤、黑色素瘤、鳞状细胞癌和腺癌。本研究的目的是明确这种罕见肿瘤的细胞学特征。
分析了9例经组织学确诊的上皮样肉瘤的细胞学特征。评估的标准包括细胞大小和形状、细胞边界、细胞团组织、细胞质特征、核及核仁特征以及背景特征。
在大多数病例中，单个分散的细胞为主要模式，仅存在少数小细胞团。细胞大多呈圆形，散在梭形细胞，具有轻度至中度的多形性。细胞核大且偏心位，呈浆细胞样外观。9例中有3例在核周区域可见淡染区。8例观察到恶性细胞之间有明确的细胞边界和细胞间间隙。3例中发现肉芽肿样结构。2例中细胞大多为梭形，显示出更大的细胞多形性。
上皮样肉瘤是一种不常见的肿瘤，鉴别诊断范围广泛，尤其是在细胞学标本中。认识到其存在并了解其细胞学特征对于正确诊断很重要。
