Department of Pathology, The Ohio State University Medical Center, Columbus, Ohio, USA.
Cancer. 2009 Dec 25;117(6):508-15. doi: 10.1002/cncy.20044.
Nuclear protein in testis (NUT) midline carcinoma (NMC) represents an aggressive, high-grade carcinoma typically involving the upper aerodigestive tract or mediastinum. Although the tumor was originally noted in young persons, we have subsequently identified 5 adult cases. To our knowledge, the cytology of NMC has not been systematically described.
We recently published a series of NMCs identified by fluorescent in situ hybridization for characteristic NUT rearrangement. Three of these patients had undergone fine-needle aspiration. Patient age, sex, primary tumor location, and aspiration site were noted. Cases were assessed for the following: cellularity, architecture, cytoplasm, cell size, nuclear contours, nucleoli, chromatin, anisonucleosis/cytosis, mitotic activity, background, and nuclear crush.
The 3 cases occurred in 2 women and 1 man, ages 31-79 years. Primaries involved the sinonasal tract (2) and larynx. Aspirates were of right neck masses (2) and supraclavicular lymph node. Smears were highly cellular and generally noncohesive. Cytoplasm was scant/delicate, although occasional cells with denser cytoplasm were noted in 1 case. Cells were 2-3 times the diameter of a small lymphocyte with irregular nuclear contours, discrete nucleoli, and fine/granular to vesicular chromatin. Anisonucleosis/cytosis was slight to moderate. Mitotic figures were noted in each case. The background contained naked nuclei and karyorrhectic debris; nuclear crush was noted.
NMCs exhibit cytologic features of a poorly differentiated or undifferentiated carcinoma. Although reports mention squamous differentiation as a histologic feature, it is typically focal, and overt squamous differentiation was not identified in our cases. Given morphologic overlap with other high-grade carcinomas, diagnosis requires a high index of suspicion.
睾丸核蛋白（NUT）中线癌（NMC）是一种侵袭性的高级别癌，通常累及上呼吸道或纵隔。尽管该肿瘤最初见于年轻人，但我们随后发现了 5 例成人病例。据我们所知，NMC 的细胞学尚未得到系统描述。
我们最近发表了一系列通过荧光原位杂交鉴定的 NMC 病例，这些病例具有特征性的 NUT 重排。其中 3 例患者接受了细针穿刺。记录了患者的年龄、性别、原发肿瘤位置和抽吸部位。对病例进行了以下评估：细胞数量、结构、细胞质、细胞大小、核轮廓、核仁、染色质、核异质/核质比、有丝分裂活性、背景和核压碎。
这 3 例发生在 2 名女性和 1 名男性，年龄 31-79 岁。原发性肿瘤累及鼻窦（2 例）和喉。抽吸物为右颈部肿块（2 例）和锁骨上淋巴结。涂片高度细胞化且通常非黏附性。细胞质稀少/细腻，但在 1 例中偶尔可见较密集的细胞质的细胞。细胞直径是小淋巴细胞的 2-3 倍，核轮廓不规则，核仁明显，染色质呈细颗粒状至泡状。核异质/核质比为轻度至中度。每个病例均可见有丝分裂象。背景中含有裸核和核碎块；注意到核压碎。
NMC 具有低分化或未分化癌的细胞学特征。尽管报告提到鳞状分化是组织学特征，但通常是局灶性的，在我们的病例中未发现明显的鳞状分化。鉴于与其他高级别癌的形态学重叠，诊断需要高度怀疑。
