Jorns Julie M, Knoepp Stewart M
Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA.
Diagn Cytopathol. 2011 Jan;39(1):35-6. doi: 10.1002/dc.21301.
Granulomatous inflammation is a relatively common finding in routine aspiration cytology of lymph nodes. However, asteroid bodies are very rarely encountered in cytologic preparations, and most morphologic descriptions result from observations made in histologic tissue sections. This brief report describes the cytologic findings in paratracheal aspirate smears from a 74-year-old Caucasian woman with the history of squamous-cell carcinoma of the right ankle metastatic to a right groin lymph node. At the time of removal of the metastatic tumor, the patient was noted to have multiple small, mildly FDG-avid lymph nodes in the supraclavicular, paratracheal, precarinal, pulmonic hilar, and axillary regions. A transbronchial fine-needle aspiration biopsy (FNAB) of a paratracheal lymph node showed granulomatous inflammation and numerous multinucleated giant cells containing asteroid bodies. No evidence of malignancy was present in any of the smears. Additional patient history elicited at the time of FNAB revealed a diagnosis 6 years previously of disseminated histoplasmosis infection. A concomitant workup for sarcoidosis was negative.
肉芽肿性炎症在淋巴结常规穿刺细胞学检查中是相对常见的发现。然而，在细胞学标本中很少见到星状体，大多数形态学描述来自于对组织学切片的观察。本简短报告描述了一名74岁白种女性的气管旁穿刺涂片的细胞学发现，该女性有右踝鳞状细胞癌转移至右侧腹股沟淋巴结的病史。在切除转移性肿瘤时，发现患者在锁骨上、气管旁、隆突前、肺门和腋窝区域有多个小的、轻度摄取氟代脱氧葡萄糖（FDG）的淋巴结。对一个气管旁淋巴结进行经支气管细针穿刺活检（FNAB），显示有肉芽肿性炎症和许多含有星状体的多核巨细胞。所有涂片均未发现恶性证据。在FNAB时获得的患者其他病史显示，6年前诊断为播散性组织胞浆菌病感染。同时进行的结节病检查结果为阴性。
