Parwani Anil V, Chan Theresa Y, Ali Syed Z
Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Cancer. 2004 Apr 25;102(2):87-91. doi: 10.1002/cncr.20161.
Psammoma bodies (PBs) are encountered only rarely in body cavity fluids (BCF). Although to the authors' knowledge their presence in certain neoplasms (e.g., those of the thyroid, ovary, lung, brain, etc.) is established, their significance in BCF has not been well defined.
Diagnoses concerning 3335 BCF samples were reviewed from the cytopathology files for the presence of PBs over an 8-year period. Cytologic preparations included cytospin preparations and Millipore filters stained with the Papanicolaou stain. Clinicopathologic correlation was performed on any subsequent surgical studies.
Of the 3335 BCF samples studies (2444 pleural samples, 688 peritoneal samples, and 203 pericardial samples), PBs were noted in 123 cases (3.7%). Of these 123 cases, 112 were the peritoneal fluid (91%), 10 were the pleural fluid (8.1%), and 1 was in the pericardial fluid (0.81%). All 11 cases of pleural and pericardial effusions with PBs were malignant (carcinomas of the thyroid, lung, and ovary) compared with 62 of 112 peritoneal fluid samples (55.4%) (carcinoma of the ovary and uterus and mesothelioma). Nine of the remaining 50 cases of cytologically benign peritoneal fluids with PBs detected on follow-up tissue biopsy demonstrated peritoneal metastases from ovarian or endometrial carcinoma. Therefore, 41 of 112 cases of peritoneal fluid with PBs remained benign even after clinical follow-up and/or tissue biopsy (36.6%) and demonstrated ovarian cystadenoma/cystadenofibroma, papillary mesothelial hyperplasia, endosalpingiosis, endometriosis, and other miscellaneous benign diagnoses.
PBs in BCF is a rare finding. Although in the authors' experience their presence in pleural and pericardial effusions signifies carcinomatous involvement, in the current study, peritoneal fluids with PBs were found to be benign in a significant number of cases (36.6%). In the latter scenario and in the absence of an obvious malignancy, attempts should be made to rule out the above-mentioned benign lesions.
砂粒体（PBs）在体腔液（BCF）中极为罕见。据作者所知，尽管其在某些肿瘤（如甲状腺、卵巢、肺、脑等肿瘤）中的存在已得到证实，但其在BCF中的意义尚未明确界定。
回顾了8年间细胞病理学档案中3335份BCF样本的诊断情况，以确定是否存在砂粒体。细胞学标本包括细胞离心涂片和用巴氏染色法染色的微孔滤膜。对任何后续的手术研究进行临床病理相关性分析。
在3335份BCF样本研究中（2444份胸腔积液样本、688份腹腔积液样本和203份心包积液样本），123例（3.7%）发现有砂粒体。在这123例中，112例为腹腔积液（91%），10例为胸腔积液（8.1%），1例为心包积液（0.81%）。所有11例胸腔和心包积液中有砂粒体的均为恶性（甲状腺、肺和卵巢癌），而112例腹腔积液样本中有62例（55.4%）（卵巢和子宫癌以及间皮瘤）。在后续组织活检中检测到的其余50例细胞学良性腹腔积液中有砂粒体的病例中，9例显示为卵巢或子宫内膜癌的腹膜转移。因此，112例腹腔积液中有砂粒体的病例中，即使经过临床随访和/或组织活检，仍有41例（36.6%）为良性，表现为卵巢囊腺瘤/囊腺纤维瘤、乳头状间皮增生、输卵管内膜异位、子宫内膜异位症以及其他各种良性诊断。
BCF中出现砂粒体是一种罕见的发现。尽管根据作者的经验，其在胸腔和心包积液中的存在表明有癌性累及，但在本研究中，大量有砂粒体的腹腔积液病例（36.6%）被发现为良性。在后一种情况下，且在无明显恶性肿瘤的情况下，应尝试排除上述良性病变。
