Köybaşioğlu Fulya, Simşek Gülçin Güler, Onal Binnur Uzmez, Han Unsal, Adabağ Ayşegül
Cytology Unit, Department of Pathology, Social Security Foundation Training Hospital, Ankara, Turkey.
Acta Cytol. 2005 Mar-Apr;49(2):173-6. doi: 10.1159/000326128.
Due to its rarity, chordoma may be difficult to differentiate from other neoplasms with a similiar myxoid background. We describe a case of chordoma involving the oropharynx inferiorly that was diagnosed by transoral fine needle aspiration (FNA) cytology (FNAC) and confirmed by histologic studies. This appears to be 1 of the few reported applications of FNA in the diagnosis of chordoma of the oropharynx in the English-language literature.
A 50-year-old male presented with nocturnal dyspnea and rare hemoptysis for 6 months. A hypodense mass was located in the left posterior side of the oropharynx. FNAC of the mass showed classic physaliferous cells with a bubbly appearance and myxoid fibrillary background. The aspirate was reported as "myxoid tumor suggestive of chordoma," as confirmed by histopathologic investigation of the excisional biopsy.
The cytologic features of chordoma are quite characteristic, especially on May-Grünwald-Giemsa (MGG)-stained slides. The cytoplasmic vacuoles of the physaliferous cells and the mucoid matrix of the tumor become conspicuous on MGG staining. When Papanicolaou staining is used as the only staining procedure, the cytoplasmic vacuoles of the physaliferous cells and mucoid matrix of chordomas may be overlooked. The differential diagnosis of myxoid tumors is of utmost importance for therapy and prognosis.
由于脊索瘤较为罕见，可能难以与其他具有类似黏液样背景的肿瘤相鉴别。我们描述了一例累及口咽下部的脊索瘤病例，该病例通过经口细针穿刺抽吸（FNA）细胞学检查（FNAC）得以诊断，并经组织学研究证实。这似乎是英文文献中少数报道的FNA在口咽脊索瘤诊断中的应用之一。
一名50岁男性，出现夜间呼吸困难和偶发咯血6个月。口咽左侧后部发现一个低密度肿块。对该肿块进行FNAC检查，发现典型的含液泡细胞，呈泡沫状外观，伴有黏液样纤维背景。吸出物报告为“提示脊索瘤的黏液样肿瘤”，切除活检的组织病理学检查证实了这一诊断。
脊索瘤的细胞学特征非常典型，尤其是在May-Grünwald-Giemsa（MGG）染色切片上。含液泡细胞的胞质空泡和肿瘤的黏液样基质在MGG染色时变得明显。当仅使用巴氏染色时，含液泡细胞的胞质空泡和脊索瘤的黏液样基质可能会被忽略。黏液样肿瘤的鉴别诊断对治疗和预后至关重要。
