Dhingra Sadhna, Krishnani Narendra, Kumari Niraj, Pandey Rakesh
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Acta Cytol. 2007 Nov-Dec;51(6):860-4. doi: 10.1159/000325861.
To evaluate the diagnostic efficacy of abdominal fat pad aspiration cytology as a screening procedure for systemic amyloidosis and to assess the clinical usefulness of semiquantitative grading criteria of fat pad amyloid deposits.
Aspiration cytology samples from 297 cases of abdominal fat pad were retrospectively analyzed for amyloid deposits. The smears were graded semiquantitatively. The deposits in the smears were compared with histologic evidence of amyloidosis in deeper tissues in 44 cases.
Retrospective analysis of 297 cases of aspiration cytology revealed amyloid in 90 cases. Follow-up biopsies from deeper tissues in 44 cases showed presence of systemic amyloidosis in 13 cases. The sensitivity and specificity of abdominal fat pad fine needle aspiration cytology was 78% and 93%, respectively. The positive predictive value was 84% and negative predictive value 90%.
Fat pad aspiration cytology is a useful screening procedure for diagnosis of systemic amyloidosis. Patients with grade 1 deposits should not undergo a toxic therapeutic regimen on the basis of fat pad cytology alone; histologic confirmation of visceral amyloid deposition in deeper tissue is advised. Patients with grades 2 and 3 deposits may undergo suitable therapy for amyloidosis.
评估腹部脂肪垫穿刺细胞学检查作为系统性淀粉样变性筛查方法的诊断效能，并评估脂肪垫淀粉样沉积物半定量分级标准的临床实用性。
对297例腹部脂肪垫穿刺细胞学样本进行回顾性分析，以检测淀粉样沉积物。涂片进行半定量分级。将涂片中的沉积物与44例深部组织淀粉样变性的组织学证据进行比较。
对297例穿刺细胞学病例的回顾性分析显示，90例存在淀粉样蛋白。44例深部组织的随访活检显示，13例存在系统性淀粉样变性。腹部脂肪垫细针穿刺细胞学检查的敏感性和特异性分别为78%和93%。阳性预测值为84%，阴性预测值为90%。
脂肪垫穿刺细胞学检查是诊断系统性淀粉样变性的一种有用的筛查方法。仅根据脂肪垫细胞学检查结果，1级沉积物患者不应接受毒性治疗方案；建议对深部组织内脏淀粉样沉积进行组织学确认。2级和3级沉积物患者可接受适当的淀粉样变性治疗。
