Batra Vineeta Vijay, Jain Shyama, Singh Deepak Kumar, Kumar Neeta
Department of Pathology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India.
Acta Cytol. 2008 Mar-Apr;52(2):152-8. doi: 10.1159/000325473.
To correlate the cytomorphologic spectrum of giant cell tumor of tendon sheath (GCTTS) with clinical and histologic findings and determine key features helpful in preoperative diagnosis.
Retrospective analysis was done on 48 cases diagnosed cytologically over 9 years. Cases were divided into 2 groups: in group 1 cytology and histology were available (12), and in group 2 cytology alone was available (36). Cytomorphologic features were correlated with clinical and histologic findings.
Patients ranged in age from 11 to 60 years, with more women. Small joint involvement was seen in all cases except 1, with upper limb involvement in most cases. Recurrence occurred in 3 cases. Aspiration smears in all cases showed high cellularity, multinucleated osteoclastic type of giant cells and stromal cells. Other features seen less frequently were cytoplasmic granules and vacuoles, nuclear grooves, inclusions, budding, focal mild pleomorphism, hemosiderin-laden macrophages and foam cells. Mitosis and necrosis were absent. Cytologic features were classified as constant when present in all cases and variable when present occasionally.
The constant cytologic features when combined with clinical and radiologic details are sufficiently distinctive of GCTTS. Fine needle aspiration cytology can be used in early, accurate preoperative diagnosis.
将腱鞘巨细胞瘤（GCTTS）的细胞形态学谱与临床及组织学表现相关联，并确定有助于术前诊断的关键特征。
对9年间经细胞学诊断的48例病例进行回顾性分析。病例分为2组：第1组有细胞学和组织学资料（12例），第2组仅有细胞学资料（36例）。将细胞形态学特征与临床及组织学表现相关联。
患者年龄在11至60岁之间，女性居多。除1例例外，所有病例均累及小关节，大多数病例累及上肢。3例出现复发。所有病例的抽吸涂片均显示细胞丰富、多核破骨细胞样巨细胞和基质细胞。较少见的其他特征包括细胞质颗粒和空泡、核沟、包涵体、芽生、局灶性轻度异型性、含铁血黄素巨噬细胞和泡沫细胞。未见有丝分裂和坏死。当在所有病例中均存在时，细胞形态学特征被分类为恒定特征；当偶尔出现时，则为可变特征。
恒定的细胞形态学特征与临床及放射学细节相结合，对GCTTS具有足够的特异性。细针穿刺细胞学检查可用于早期准确的术前诊断。
