Kapila Kusum, Ghosal Nandita, Gill Satyajit Singh, Verma Kusum
Cytology Laboratory, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India.
Acta Cytol. 2003 Jul-Aug;47(4):555-62. doi: 10.1159/000326568.
To evaluate the cytomorphologic features of benign and malignant lipomatous tumors of soft tissue on fine needle aspirates (FNA) and determine if the variants of liposarcoma could be identified.
FNA of histologically documented benign (51 cases) and malignant (39 cases) lipomatous tumors were reviewed. Twenty-six of the 51 FNA from lipomas and 34 of the 39 FNA from malignant lipomatous tumors were satisfactory for evaluation.
FNA from 26 cases of lipomas were cellular, with lobulated, fibroadipose tissue. Thin and thick capillaries were seen in 92% and 65% of cases, though a chicken wire vascular pattern was seen in only 4 cases (15%). A cytodiagnosis of liposarcoma could be made in 23 cases (88%), and these could be further subtyped into well-differentiated (4 cases), myxoid (8), pleomorphic (4), round cell (3) and liposarcoma, ?type (4). Only 50% of the well-differentiated liposarcomas, 3 of the 10 pleomorphic liposarcomas and 8 of the 17 myxoid liposarcomas were diagnosed as such on FNA. Cytologic diagnosis of the remaining 9 cases of myxoid liposarcoma were pleomorphic liposarcoma (1); liposarcoma, ?type (3); malignant mesenchymal tumor (1); suspicious for malignancy (2); and benign (2). There were no false positives, but there were 3 false negative cases (1 well-differentiated and 2 myxoid liposarcoma).
Lipomas can be diagnosed readily. Arborizing vessels can be seen in lipomas and should be interpreted with caution. Subclassification of liposarcomas on FNA is possible but not very reliable. Myxoid liposarcomas pose a problem, and aspirates from them can mimic a wide range of morphologic subtypes. The role of FNA in identification of variants of liposarcoma is limited.
评估软组织良恶性脂肪瘤性肿瘤细针穿刺抽吸物（FNA）的细胞形态学特征，并确定是否能识别脂肪肉瘤的亚型。
回顾经组织学证实的良性（51例）和恶性（39例）脂肪瘤性肿瘤的FNA。51例脂肪瘤的FNA中有26例、39例恶性脂肪瘤性肿瘤的FNA中有34例适合评估。
26例脂肪瘤的FNA有细胞成分，含分叶状纤维脂肪组织。92%的病例可见细毛细血管，65%的病例可见粗毛细血管，仅4例（15%）可见筛状血管模式。23例（88%）可做出脂肪肉瘤的细胞诊断，这些可进一步分为高分化型（4例）、黏液型（8例）、多形型（4例）、圆形细胞型（3例）和未定型脂肪肉瘤（4例）。高分化脂肪肉瘤中只有50%、10例多形性脂肪肉瘤中的3例以及17例黏液型脂肪肉瘤中的8例在FNA上被诊断为此类。其余9例黏液型脂肪肉瘤的细胞学诊断为多形性脂肪肉瘤（1例）；未定型脂肪肉瘤（3例）；恶性间叶性肿瘤（1例）；可疑恶性（2例）；以及良性（2例）。无假阳性，但有3例假阴性病例（1例高分化和2例黏液型脂肪肉瘤）。
脂肪瘤可轻易诊断。脂肪瘤中可见树枝状血管，应谨慎解读。FNA上脂肪肉瘤的亚型分类是可能的，但不太可靠。黏液型脂肪肉瘤存在问题，其抽吸物可模拟多种形态学亚型。FNA在识别脂肪肉瘤亚型中的作用有限。
