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细针穿刺活检中酷似良性黏液性肿瘤的肺腺肌样错构瘤:一例报告

Adenomyomatous hamartoma of lung mimicking benign mucinous tumor in fine needle aspiration biopsy: a case report.

作者信息

Jin Min-Sun, Ha Hwa-Jeong, Baek Hee Jong, Lee Jae Cheol, Koh Jae Soo

机构信息

Department of Pathology, Thoracic Surgery, Internal Medicine, Korea Cancer Center Hospital, Korean Institute of Radiological and Medical Science, Seoul, Korea.

出版信息

Acta Cytol. 2008 May-Jun;52(3):357-60. doi: 10.1159/000325523.

Abstract

BACKGROUND

Typical cytologic features of pulmonary hamartoma (PH) are usually smears of hyaline cartilage, fibrous tissue, smooth muscle, adipocytic components and respiratory epithelium. Cytologic features of adenomyomatous hamartoma, a special variant of PH, are not documented in the literature and are confused with epithelial neoplasm in the case of sparse stromal cellularity.

CASE

A 59-year-old man presented with a solitary pulmonary nodule by chest radiograph at his routine health examination. Fine needle aspiration biopsy (FNAB) revealed numerous mucinous epithelial cells presenting predominantly in cohesive cellular sheets that suggested benign mucinous epithelial lesion. The patient underwent surgery for the tumor, and it was histologically proven to be an adenomyomatous hamartoma.

CONCLUSION

An unusual type of PH could lead to misdiagnosis by FNAB in the case of few stromal components. This case demonstrates the wide spectrum of PH in FNAB and led us to consider PH as a differential diagnosis despite lack of chondromyxoid stromal components.

摘要

背景

肺错构瘤(PH)典型的细胞学特征通常为透明软骨、纤维组织、平滑肌、脂肪细胞成分及呼吸上皮的涂片表现。腺肌瘤样错构瘤是PH的一种特殊变体,其细胞学特征在文献中尚无记载,且在间质细胞稀少的情况下易与上皮性肿瘤相混淆。

病例

一名59岁男性在常规健康检查时胸部X线片显示有一个孤立性肺结节。细针穿刺活检(FNAB)显示大量黏液性上皮细胞,主要呈聚集的细胞片,提示为良性黏液性上皮病变。患者接受了肿瘤手术,组织学证实为腺肌瘤样错构瘤。

结论

在间质成分较少的情况下,一种不常见类型的PH可能会导致FNAB误诊。该病例显示了FNAB中PH的广泛表现谱,使我们即使在缺乏软骨黏液样间质成分的情况下也将PH列为鉴别诊断之一。

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