Bellizzi Andrew M, Bourne T David, Mills Stacey E, Stelow Edward B
Department of Pathology, University of Virginia Health System, Charlottesville, VA 22908, USA.
Am J Clin Pathol. 2008 Mar;129(3):367-76. doi: 10.1309/C00WN1HHJ9AMBJVT.
Sinonasal undifferentiated carcinoma (SNUC) is a rare, aggressive malignancy of the sinonasal tract. Olfactory neuroblastoma (ONB) is an uncommon neuroectodermal tumor of the superior nasal cavity. Upon examining these lesions, a broad differential diagnosis of poorly differentiated round cell tumors must be considered. The cytologic features of SNUC and ONB have been rarely reported. We searched our cytology files for cases of SNUC and ONB and assessed the following: cellularity, architecture, cytoplasm, cell size, nuclear contours, nucleoli, chromatin, anisonucleosis/anisocytosis, mitotic activity, background, and nuclear crush. Seven cases of SNUC produced hypercellular smears with a single-cell-predominant pattern. Cells were intermediate-sized with irregular nuclear contours and small nucleoli. Nuclear crush and mitotic figures were noted. The background exhibited naked nuclei and karyorrhectic debris. Of 7 cases, 6 (86%) exhibited vacuoles or extracellular lumina. The 10 cases of ONB exhibited cellularity, cellular arrangement, and chromatin similar to SNUC. In contrast, ONBs demonstrated fibrillary cytoplasm and smooth nuclear contours; mitotic figures were generally absent. Homer Wright rosettes were encountered in 9 cases (90%). We believe that in the appropriate clinical context, a specific cytologic diagnosis should be possible.
鼻窦未分化癌（SNUC）是一种罕见的、侵袭性鼻窦恶性肿瘤。嗅神经母细胞瘤（ONB）是一种少见的鼻腔上部神经外胚层肿瘤。在检查这些病变时，必须考虑对低分化圆形细胞瘤进行广泛的鉴别诊断。关于SNUC和ONB的细胞学特征报道很少。我们在细胞学档案中查找SNUC和ONB病例，并评估以下方面：细胞密度、结构、细胞质、细胞大小、核轮廓、核仁、染色质、核大小不均/细胞大小不均、有丝分裂活性、背景及核挤压。7例SNUC产生细胞密度高的涂片，以单细胞为主型。细胞中等大小，核轮廓不规则，核仁小。可见核挤压和有丝分裂象。背景显示裸核和核溶解碎片。7例中有6例（86%）出现空泡或细胞外腔隙。10例ONB的细胞密度、细胞排列和染色质与SNUC相似。相比之下，ONB显示出纤维状细胞质和平滑的核轮廓；一般无有丝分裂象。9例（90%）可见霍纳·赖特菊形团。我们认为，在适当的临床背景下，进行特异性细胞学诊断是可行的。
