Department of Pathology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Cancer. 2009 Dec 25;117(6):500-7. doi: 10.1002/cncy.20054.
Alveolar soft part sarcoma (ASPS) rarely is subjected to cytopathologic evaluation. With the exception of some very small series, the literature is limited to case reports. The objectives of the current study were to evaluate the cytomorphology of 10 ASPS cases on fine-needle aspiration (FNA) or imprint cytology, review the literature, and highlight potential diagnostic pitfalls.
The authors searched their files for all lesions that were signed out as ASPS or suspicious for ASPS and searched the surgical pathology files for any cases of ASPS that had corresponding cytology. FNA was performed using the standard technique. Scrape preparations were performed on tissues that were sent fresh for frozen section examination.
Ten cases of ASPS were retrieved from 7 patients (male-to-female ratio, 4:3; mean age, 22 years). All had subsequent tissue confirmation. Six specimens were from primary lesions, 3 specimens were from metastases, and 1 intraoperative smear was from a previously aspirated primary mass in a newly diagnosed patient. Anatomic sites of involvement included extremities (5 specimens), trunk/pelvis (3 specimens), oral cavity (1 specimen), and lung (1 specimen). Eight specimens were aspirates, and 2 specimens were intraoperative smears. Nine cases were diagnosed correctly as ASPS/consistent with ASPS, and 1 specimen was diagnosed as "tumor, not otherwise specified". Cytomorphology included variably cellular smears composed of large cells with an enormous amount of finely granular or vacuolated cytoplasm, markedly enlarged nuclei/nucleoli, and bare nuclei. The cytomorphology of some cases revealed a strong similarity to renal cell carcinoma, clear cell type.
The results of the current study indicated that ASPS has cytomorphology that overlaps with several other neoplasms, including renal cell carcinoma. Nonetheless, the morphologic features, when combined with the clinical presentation, radiologic findings, and ancillary testing, may allow for a specific diagnosis.
肺泡软组织肉瘤（ASPS）很少进行细胞学评估。除了一些非常小的系列，文献仅限于病例报告。本研究的目的是评估 10 例 ASPS 细针抽吸（FNA）或印模细胞学的细胞形态学，回顾文献，并强调潜在的诊断陷阱。
作者在文件中搜索所有被标记为 ASPS 或疑似 ASPS 的病变，并在外科病理学文件中搜索任何有相应细胞学的 ASPS 病例。FNA 采用标准技术进行。对送新鲜进行冷冻切片检查的组织进行刮片。
从 7 名患者中检索到 10 例 ASPS（男女比例为 4:3；平均年龄为 22 岁）。所有患者均有后续组织证实。6 例标本来自原发性病变，3 例来自转移灶，1 例术中涂片来自新诊断患者先前抽吸的原发性肿块。受累的解剖部位包括四肢（5 例标本）、躯干/骨盆（3 例标本）、口腔（1 例标本）和肺（1 例标本）。8 例标本为抽吸物，2 例为术中涂片。9 例正确诊断为 ASPS/符合 ASPS，1 例诊断为“肿瘤，未特指”。细胞形态学包括由大细胞组成的不同程度的细胞涂片，大细胞具有大量精细颗粒或空泡状细胞质，明显增大的核/核仁，以及裸核。一些病例的细胞形态学与肾细胞癌、透明细胞型非常相似。
本研究结果表明，ASPS 的细胞形态与其他几种肿瘤重叠，包括肾细胞癌。尽管如此，形态特征，结合临床表现、影像学发现和辅助检查，可能允许做出明确的诊断。
