Can Bilge, Akpolat Ilkser, Meydan Deniz, Üner Ayşegül, Kandemir Bedri, Söylemezoğlu Figen
Department of Pathology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Acta Cytol. 2012;56(1):97-103. doi: 10.1159/000331769. Epub 2012 Jan 4.
Systemic metastasis of a glial tumor is a rare event. However, metastatic cases are anticipated to increase due to prolongation of survival as a result of the development of new treatment modalities. The possibility of metastasis should be considered in patients with a history of a glial tumor rather than a second primary tumor. Fine-needle aspiration cytology is one of the diagnostic procedures primarily applied for confirmation of metastasis in cases with a known primary focus. Therefore, comprehensive knowledge of diagnostic cytomorphologic findings is required in these cases.
We report a young woman with oligodendroglioma metastasizing to the cervical lymphatic chain 5 years after initial diagnosis. Fine-needle aspiration cytology revealed a highly cellular smear with dispersed single cells and loosely cohesive cell clusters showing rosette-like features on a clean background. The relatively monotonous tumor cells were small sized and had round nuclei with moderate anisonucleosis and scant cytoplasm without extensions. Diagnostic confirmation was made by excisional biopsy and demonstration of 1p19q codeletion on tissue section by fluorescence in situ hybridization.
A brief review of the literature with an emphasis on the cytologic features of metastatic oligodendroglioma and differential diagnosis with respect to other metastatic small round cell tumors is provided.
胶质细胞瘤的全身转移是一种罕见事件。然而,由于新治疗方式的发展延长了生存期,预计转移病例将会增加。对于有胶质细胞瘤病史的患者,应考虑转移的可能性,而非继发原发性肿瘤。细针穿刺细胞学检查是主要用于确诊已知原发灶病例转移情况的诊断方法之一。因此,在这些病例中需要全面了解诊断性细胞形态学表现。
我们报告了一名年轻女性,其少突胶质细胞瘤在初次诊断5年后转移至颈部淋巴链。细针穿刺细胞学检查显示涂片细胞丰富,有散在的单个细胞和松散聚集的细胞团,在干净背景下呈现玫瑰花结样特征。相对单一的肿瘤细胞体积较小,核圆形,核大小不均中等,胞质稀少且无突起。通过切除活检及荧光原位杂交在组织切片上显示1p19q共缺失得以确诊。
本文对文献进行简要综述,重点阐述转移性少突胶质细胞瘤的细胞学特征以及与其他转移性小圆形细胞肿瘤的鉴别诊断。