Crapanzano John P, Cardillo Marina, Lin Oscar, Zakowski Maureen F
Cytology Service, Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Cancer. 2002 Feb 25;96(1):21-31. doi: 10.1002/cncr.10316.
Desmoplastic small round cell tumor (DSRCT) is a high-grade malignant tumor that has a predilection for adolescent males and usually affects the abdominal cavity. The cytology literature regarding DSRCT, including aspirates and ascitic fluid, is limited. To the authors' knowledge, findings in ThinPrep slides have not been described previously.
Seven cytologic specimens from five patients with histologically confirmed DSRCT were reviewed. Five specimens were fine-needle aspiration biopsies (FNABs), (liver, flank soft tissue, abdomen, and two resected colons [pericolic]) and two specimens were ascitic fluid. Cytologic features were studied in ThinPrep slides and direct smears, which included hematoxylin and eosin, Papanicolaou, and Quik-Dip stains.
All specimens showed moderate to high cellularity. The tumor cells were arranged singly and in clusters. The cells demonstrated high nuclear/cytoplasmic ratios, granular chromatin reminiscent of small cell carcinoma, usually inconspicuous nucleoli, smooth to irregular nuclear membranes, and frequent nuclear molding. The cytoplasm was scant to moderate, pale blue, and occasionally vacuolated. Pseudorosettes were observed in six specimens. One ThinPrep slide and the direct smears contained cells with perinuclear, cytoplasmic densities. Stromal fragments were present in the direct smears but were uncommon in ThinPrep. Three specimens were diagnosed as being consistent with DSRCT. Two specimens were diagnosed as malignant small cell tumor. Molecular studies performed on histologic material in four cases confirmed the presence of the diagnostic translocation, t(11;22)(p13;q12).
DSRCT may be diagnosed accurately in cytology specimens. Characteristic cytologic features include granular chromatin, smooth to irregular nuclear membranes, nuclear molding, cytoplasmic vacuoles, pseudorosettes, and metachromatic stroma. Cytoplasmic densities may be observed in direct smears and ThinPrep slides.
促结缔组织增生性小圆细胞肿瘤（DSRCT）是一种高级别恶性肿瘤，好发于青春期男性，通常累及腹腔。关于DSRCT的细胞学文献，包括细针穿刺抽吸物和腹水，较为有限。据作者所知，此前尚未描述过ThinPrep玻片上的发现。
回顾了5例经组织学确诊为DSRCT患者的7份细胞学标本。5份标本为细针穿刺活检（FNAB）（肝脏、侧腹软组织、腹部以及两个切除的结肠[结肠旁]），2份标本为腹水。在ThinPrep玻片和直接涂片上研究细胞学特征，包括苏木精和伊红染色、巴氏染色以及快速浸蘸染色。
所有标本均显示细胞数量中等至高。肿瘤细胞呈单个及簇状排列。细胞显示出高核质比、颗粒状染色质，类似小细胞癌，通常核仁不明显，核膜光滑至不规则，且常见核异型。细胞质稀少至中等，淡蓝色，偶尔有空泡。6份标本中观察到假菊形团。1张ThinPrep玻片和直接涂片上含有核周、细胞质致密的细胞。直接涂片上存在间质碎片，但在ThinPrep中不常见。3份标本诊断为符合DSRCT。2份标本诊断为恶性小细胞肿瘤。对4例组织学材料进行的分子研究证实存在诊断性易位t(11;22)(p13;q12)。
DSRCT可在细胞学标本中准确诊断。特征性细胞学特征包括颗粒状染色质、光滑至不规则的核膜、核异型、细胞质空泡、假菊形团以及异染性间质。在直接涂片和ThinPrep玻片上可观察到细胞质致密。
