Choi Hyun Joo, Park In Ae
Department of Pathology, Seoul National University Hospital, Clinical Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
Acta Cytol. 2004 Jan-Feb;48(1):91-4. doi: 10.1159/000326291.
While choriocarcinoma is a rapidly invasive, widely metastasizing malignancy, it responds well to chemotherapy, so it is important to obtain an early diagnosis. We report the fine needle aspiration cytology (FNAC) of a case of choriocarcinoma metastatic to the breast.
A 48-year-old female presented with a cough, hemoptysis and epistaxis. Chest computed tomography revealed multiple nodules in both lung fields. Also, a firm, slightly tender mass in the lower outer quadrant of the left breast was palpated. The breast mass was clinically suspected to be a metastatic lung cancer. FNAC of the breast showed a malignant tumor that had been misdiagnosed as a metastatic non-small cell carcinoma of the lung. Histologic examination of a nasal biopsy revealed metastatic choriocarcinoma.
The cytologic features of choriocarcinoma are quite characteristic, with side-by-side, malignant, mononucleated cells and multinucleated giant cells corresponding to cytotrophoblasts and syncytiotrophoblasts, respectively. The disease is possible to diagnose by a careful examination of FNAC samples.
绒毛膜癌是一种侵袭性强、广泛转移的恶性肿瘤，但对化疗反应良好，因此早期诊断很重要。我们报告了一例转移至乳腺的绒毛膜癌的细针穿刺细胞学检查（FNAC）情况。
一名48岁女性出现咳嗽、咯血和鼻出血症状。胸部计算机断层扫描显示双肺野有多个结节。此外，在左乳房外下象限可触及一个质地坚硬、稍有压痛的肿块。临床怀疑该乳腺肿块为转移性肺癌。乳腺的FNAC显示为恶性肿瘤，曾被误诊为肺转移性非小细胞癌。鼻活检的组织学检查显示为转移性绒毛膜癌。
绒毛膜癌的细胞学特征非常典型，并列的恶性单核细胞和多核巨细胞分别对应细胞滋养层细胞和合体滋养层细胞。通过仔细检查FNAC样本有可能诊断该病。
