Gu Mai, Ghafari Sophie, Lin Fritz, Ramzy Ibrahim
Department of Pathology, University of California Irvine Medical Center, 101 The City Dr., Orange, CA 92868, USA.
Diagn Cytopathol. 2005 Apr;32(4):204-10. doi: 10.1002/dc.20224.
The aim of this study was to evaluate the efficacy and accuracy of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) in the diagnosis of pancreatic endocrine tumors and to analyze their cytomorphology. Between March 1999 and June 2004, a total of 30 patients with a cytological diagnosis of pancreatic endocrine tumors were found. Their records were retrieved and the cytological materials were analyzed. The mean size of the tumors assessed by EUS was 3.0 cm. Immediate preliminary interpretation was rendered after an average of 1.5 passes. Based on the cellular patterns, cases were divided into three categories: loosely cohesive aggregates, discohesive single cells, and cohesive flat sheets. Most tumor cells had abundant cytoplasm and eccentric nuclei. Chromatin was fine or coarse but was evenly distributed in all cases. Nuclear pleomorphism, multinucleation, intranuclear inclusions, mitotic figures, and necrosis were seen. Immunohistochemical (IHC) studies on cell blocks confirmed the diagnosis in all cases. EUS-guided FNA is efficient and accurate in establishing the diagnosis of pancreatic endocrine tumors. The variety of cellular patterns presents several differential diagnostic issues that should be considered to avoid erroneous interpretation.
本研究旨在评估内镜超声（EUS）引导下细针穿刺抽吸（FNA）在胰腺内分泌肿瘤诊断中的有效性和准确性，并分析其细胞形态学。1999年3月至2004年6月期间，共发现30例经细胞学诊断为胰腺内分泌肿瘤的患者。检索了他们的病历并分析了细胞学材料。经EUS评估，肿瘤的平均大小为3.0 cm。平均穿刺1.5次后立即进行初步解读。根据细胞形态，病例分为三类：松散聚集的细胞团、分散的单个细胞和紧密相连的扁平细胞片。大多数肿瘤细胞具有丰富的细胞质和偏心核。染色质细或粗，但在所有病例中分布均匀。可见核异型性、多核、核内包涵体、有丝分裂象和坏死。对细胞块进行的免疫组织化学（IHC）研究在所有病例中均证实了诊断。EUS引导下的FNA在确立胰腺内分泌肿瘤的诊断方面有效且准确。细胞形态的多样性提出了几个鉴别诊断问题，应予以考虑以避免错误解读。
