肺嗜酸性细胞瘤样类癌：支气管冲洗液滤膜制备中诊断陷阱的病例报告
Oncocytic carcinoid tumor of the lung: a case report of diagnostic pitfall in filter membrane preparation of bronchial washings.
作者信息
Arora Raman, Mathur Sandeep R, Aron Manju, Verma Kusum, Iyer Venkateswaran K, Arora Vinod K, Sharma Meher C
机构信息
Cytology Laboratory, Department of Pathology, All India Institute of Medical Sciences, and Sir Gangaram Hospital, New Delhi, India.
出版信息
Acta Cytol. 2007 Nov-Dec;51(6):907-10. doi: 10.1159/000325868.
BACKGROUND
Oncocytic carcinoid tumor of the lung is a rare variant of pulmonary carcinoid. This report describes the morphologic appearance of this rare tumor on filter membrane preparation along with potential pitfalls.
CASE
A 49-year-old woman presented with cough and expectoration. On chest radiograph a mass lesion was seen in the upper zone of the right lung. Bronchial washings were sent for evaluation. On filter membrane (Millipore) preparation of bronchial washing the possibility of a non-small cell carcinoma, possibly squamous, was suggested. Right upper lobectomy was subsequently performed and a histologic diagnosis of oncocytic carcinoid given. The cytomorphologic features of this tumor on the Millipore preparation were reviewed.
CONCLUSION
Differential diagnosis of oncocytic carcinoid should be kept in mind while assessing cytologic material when tumor cells show abundant granular cytoplasm and prominent nucleoli. Oncocytic carcinoid also must be differentiated from oncocytoma and granular cell tumor. Immunocytochemistry and electron microscopy are useful in confirming the diagnosis.
背景
肺嗜酸细胞性类癌是肺类癌的一种罕见变异型。本报告描述了这种罕见肿瘤在滤膜制片上的形态学表现以及潜在的陷阱。
病例
一名49岁女性，表现为咳嗽和咳痰。胸部X线片显示右肺上叶有一肿块。支气管冲洗液送检评估。在支气管冲洗液的滤膜（密理博）制片上，提示可能为非小细胞癌，可能为鳞状细胞癌。随后行右上叶切除术，组织学诊断为嗜酸细胞性类癌。回顾了该肿瘤在密理博制片上的细胞形态学特征。
结论
当肿瘤细胞显示丰富的颗粒状胞质和明显核仁时，在评估细胞学材料时应牢记嗜酸细胞性类癌的鉴别诊断。嗜酸细胞性类癌还必须与嗜酸细胞瘤和颗粒细胞瘤相鉴别。免疫细胞化学和电子显微镜检查有助于确诊。
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