Romero-Guadarrama Mónica B, Jiménez-Becerra Silvia, Durán-Padilla Marco A, Santiago-Prieto Ana Cecilia, Cruz-Ortiz Humberto, Novelo-Retana Virginia
Pathology Unit, Hospital General de México.
Acta Cytol. 2007 May-Jun;51(3):440-2. doi: 10.1159/000325763.
Progress in radiology and pathology for diagnosing mediastinal tumors has R been made in recent decades, thanks to the use of fine needle aspiration biopsy (FNAB) guided by computed tomography, which has replaced mediastinoscopy and open biopsies.
A 66-year-old male had a history o productive coughing with mucopurulent expectoration, progressive dyspnea, arthralgias, myalgias, astenia and adynamia for the previous 3 months. A CT scan and magnetic resonance imaging revealed a poorly limited tumor mass ofheterogeneous den sity in the anterior mediastinum. FNAB of the tumor mass showed malignant cells compatible with liposarcoma. CONCLUSLON: Of the several types of mesenchymal mediastinal neoplasms, liposarcoma is the most important. Many of them are seen in adults, and <10 cases have been diagnosed in children. The symptoms are related to compression of the nearby airways. Usually liposarcomas are yellow, lobed tumors without capsules that infiltrate adjacent organs and tissues. Microscopically, they have the same histologic spectrum as tumors originating in other sites. Thus, it is common to observe all the histologic varieties of soft tissue liposarcomas. The identification of lipoblasts is the key to the correct diagnosis in FNAB material.
近几十年来,由于在计算机断层扫描引导下进行细针穿刺活检(FNAB),放射学和病理学在纵隔肿瘤诊断方面取得了进展,这种方法已取代了纵隔镜检查和开放活检。
一名66岁男性在过去3个月中有咳痰伴黏液脓性痰、进行性呼吸困难、关节痛、肌痛、乏力和活动耐力下降的病史。CT扫描和磁共振成像显示前纵隔有一个边界不清、密度不均匀的肿瘤肿块。对该肿瘤肿块进行细针穿刺活检显示恶性细胞,符合脂肪肉瘤。
在几种纵隔间叶性肿瘤中,脂肪肉瘤最为重要。其中许多发生于成人,儿童诊断病例<10例。症状与邻近气道受压有关。脂肪肉瘤通常为黄色、分叶状肿瘤,无包膜,可浸润邻近器官和组织。在显微镜下,它们具有与起源于其他部位的肿瘤相同的组织学谱。因此,在细针穿刺活检材料中观察到软组织脂肪肉瘤的所有组织学类型很常见。鉴定脂母细胞是细针穿刺活检材料正确诊断的关键。