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肋骨良性纤维组织细胞瘤的细胞诊断及诊断困境:一例报告

Cytodiagnosis of benign fibrous histiocytoma of rib and diagnostic dilemma: a case report.

作者信息

Mondal Santosh Kumar

机构信息

Department of Pathology, Medical College, Kolkata, West Bengal, India.

出版信息

Diagn Cytopathol. 2010 Jun;38(6):457-60. doi: 10.1002/dc.21245.

Abstract

Benign fibrous histiocytoma (BFH) of bone is rare in occurrence, and rib is an unusual site. There are limited case reports of this entity in the literature, and cytodiagnosis of this tumor is not described. A 24-year-old man presented with a firm mass and pain in the right lateral chest wall. Radiological investigations (plain radiograph and computed tomography) revealed a lytic bone lesion involving the 5th rib. Radiologically, giant cell tumor (GCT), BFH, and plasmacytoma were suspected. In fine-needle aspiration cytology (FNAC), admixture of benign stromal cells and scattered osteoclast type giant cells were found in the smears. Differential diagnoses of BFH, GCT (non-epiphyseal type), fibrous dysplasia, and aneurysmal bone cyst were made on cytology. Subsequent histologic examination confirmed the diagnosis of BFH. Cytologic diagnosis of BFH of rib is difficult as this tumor may mimic other giant cell containing tumors of bone in FNAC. The final diagnosis should always be made after correlation with histological, radiological, and clinical features.

摘要

骨良性纤维组织细胞瘤(BFH)较为罕见,肋骨是其不常见的发病部位。文献中关于该实体的病例报告有限,且未描述该肿瘤的细胞诊断。一名24岁男性因右侧胸壁出现坚硬肿块和疼痛前来就诊。放射学检查(X线平片和计算机断层扫描)显示第5肋骨有溶骨性骨病变。放射学上怀疑为骨巨细胞瘤(GCT)、BFH和浆细胞瘤。在细针穿刺细胞学检查(FNAC)中,涂片发现良性基质细胞和散在的破骨细胞型巨细胞混合存在。通过细胞学对BFH、GCT(非骨骺型)、骨纤维异常增殖症和骨动脉瘤样囊肿进行了鉴别诊断。随后的组织学检查证实了BFH的诊断。肋骨BFH的细胞诊断困难,因为在FNAC中该肿瘤可能酷似其他含巨细胞的骨肿瘤。最终诊断应始终在结合组织学、放射学和临床特征后做出。

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