Department of Pathology, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
Am J Clin Pathol. 2010 Feb;133(2):224-31. doi: 10.1309/AJCPBWJP3CG6JZKA.
We reviewed our cytopathology databases for an 11-year period to identify all fine-needle aspiration biopsy (FNAB) cases of palpable masses of the hand, wrist, ankle, or foot. Cases were included only if there was a subsequent tissue biopsy or a minimum 1-year clinical follow-up. Of 141 aspirates, 41, 23, 34, and 43 were from the hand, wrist, ankle, and foot, respectively. Specific benign or malignant diagnoses were achievable in 71.6% of cases, whereas the remaining cases were given a descriptive diagnosis (26.2%) or, infrequently, a "suspicious for" diagnosis (2.1%). Overall sensitivity and specificity for distinguishing a benign from malignant entity from all 4 sites were 100% and 96%, respectively, whereas positive and negative predictive values were 88% and 100%, respectively. The most common lesion was a ganglion. Of the benign neoplasms, giant cell tumor of tendon sheath (17) and desmoid-type fibromatosis (7) were most common. Of 31 malignancies, 24 were sarcomas: sarcoma not otherwise specified (6), high-grade pleomorphic sarcoma (5), and Ewing sarcoma (3) were most common. Seven nonsarcomas included melanoma (3), metastatic squamous carcinoma (2), and malignant lymphoma (2). An FNAB-procured cytopathologic diagnosis is clinically reliable in a high percentage of distal extremity mass lesions.
我们回顾了 11 年来的细胞病理学数据库，以确定所有手部、腕部、踝部或足部可触及肿块的细针抽吸活检 (FNAB) 病例。只有在随后进行了组织活检或至少进行了 1 年的临床随访的情况下，才将病例包括在内。在 141 例抽吸物中，手部、腕部、踝部和足部分别为 41、23、34 和 43 例。在 71.6%的病例中可以做出明确的良性或恶性诊断，而其余病例则给出了描述性诊断（26.2%）或偶尔给出了“疑似”诊断（2.1%）。从所有 4 个部位区分良性和恶性实体的总体敏感性和特异性分别为 100%和 96%，阳性和阴性预测值分别为 88%和 100%。最常见的病变是神经鞘瘤。在良性肿瘤中，腱鞘巨细胞瘤（17 例）和硬纤维瘤（7 例）最常见。在 31 例恶性肿瘤中，24 例为肉瘤：未特指的肉瘤（6 例）、高级别多形性肉瘤（5 例）和尤因肉瘤（3 例）最常见。7 例非肉瘤包括黑色素瘤（3 例）、转移性鳞状细胞癌（2 例）和恶性淋巴瘤（2 例）。FNAB 获得的细胞学诊断在很大比例的远端肢体肿块病变中具有临床可靠性。
