Collins Brian T, Warrick Joshua
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110-1093, USA.
Acta Cytol. 2012;56(5):495-500. doi: 10.1159/000342532. Epub 2012 Sep 27.
Celiac ganglia are normal anatomic structures located in the region of the celiac artery and can vary in size from 5 mm to 4.5 cm. These nodules can be visualized by endoscopic ultrasound (EUS) and be subject to fine needle aspiration (FNA) biopsy. They can be identified in patients with and without underlying pathology and present a challenge in accurate interpretation.
The hospital database was retrospectively searched for patients who had undergone EUS FNA and where a diagnosis of 'ganglia' was rendered. Clinical and demographic data were collected and the cases reviewed for cytomorphologic features.
Aspirate smears were generally hypocellular with variable cellularity between aspirate passes, showing dispersed single large epithelioid cells with cytoplasmic pigmentation, small groups of bland stroma and spindled cells, as well as 'grape-like' groups with peripheral epithelioid cells and central stroma with spindled elements.
EUS cannot always definitively identify celiac lesions and the use of EUS FNA can help to accurately classify these cases. In patients with known or suspected malignancy, the accurate identification of celiac ganglia by EUS FNA can have important patient management implications. EUS FNA can identify celiac ganglia and show the distinctive features of large pigmented epithelioid ganglion cells and background neural elements.
腹腔神经节是位于腹腔动脉区域的正常解剖结构，大小可从5毫米至4.5厘米不等。这些结节可通过超声内镜（EUS）观察到，并可进行细针穿刺抽吸（FNA）活检。无论患者有无潜在病理情况，均可发现这些结节，准确解读存在挑战。
对医院数据库进行回顾性检索，查找接受过EUS FNA且诊断为“神经节”的患者。收集临床和人口统计学数据，并对病例的细胞形态学特征进行回顾。
抽吸涂片通常细胞含量少，不同抽吸样本间细胞含量各异，可见分散的单个大上皮样细胞伴有细胞质色素沉着、少量温和的间质细胞和梭形细胞，以及外周为上皮样细胞、中央为含梭形成分的间质的“葡萄样”细胞团。
EUS并非总能明确识别腹腔病变，EUS FNA有助于准确分类这些病例。对于已知或疑似恶性肿瘤的患者，EUS FNA准确识别腹腔神经节对患者管理具有重要意义。EUS FNA可识别腹腔神经节，并显示大的色素沉着上皮样神经节细胞和背景神经成分的独特特征。
