Chen Liansong, Raza Anwar S, Simental Raul G, Iverson Kiva T, Cobb Camilla J
Department of Pathology, Los Angeles County + University of Southern California Medical Center, Los Angeles, California.
Diagn Cytopathol. 2014 Feb;42(2):143-6. doi: 10.1002/dc.23018. Epub 2013 Jun 1.
For the fine-needle aspiration (FNA) diagnosis of melanoma recognition of characteristic morphologic features is key. In our practice we noted that cytoplasmic vacuoles in Romanowsky-stained FNA smears of melanoma appeared to be a frequent finding. To investigate this premise, we examined 36 consecutive melanoma FNA cases that had both adequate Papanicolaou-stained and Romanowsky-stained smears in an effort to determine the prevalence, and thereby, the potential diagnostic utility of cytoplasmic vacuoles in the diagnosis of melanoma compared to established cytomorphologic parameters of melanoma. We found pigment in 21 cases (58%) and plasmacytoid cells in 28 cases (78%), and in all 36 cases (100%) we found bi/multinucleation, intranuclear cytoplasmic inclusions and prominent nucleoli. Cytoplasmic vacuoles were present in 30 cases (83%) and were found in air-dried Romanowsky-stained smears only. These findings suggest that in FNA smears of melanoma cytoplasmic vacuoles in Romanowsky-stained smears have prevalence and potential diagnostic utility that are comparable to widely recognized cytomorphologic features of melanoma. Numerous articles have focused on the cytomorphologic criteria for the FNA diagnosis of melanoma, but few have noted the presence of cytoplasmic vacuoles in FNA smears of melanoma, and rare reports suggest this finding to be a useful clue to the FNA diagnosis of melanoma. This report appears to be the first to focus on the prevalence and potential diagnostic utility of cytoplasmic vacuoles in FNA samples of melanoma.
对于黑色素瘤的细针穿刺抽吸（FNA）诊断而言，识别特征性形态学特征是关键。在我们的实践中，我们注意到黑色素瘤的Romanowsky染色FNA涂片上的细胞质空泡似乎是一个常见发现。为了研究这一前提，我们检查了36例连续的黑色素瘤FNA病例，这些病例同时有足够的巴氏染色涂片和Romanowsky染色涂片，以确定细胞质空泡的患病率，从而确定与黑色素瘤既定的细胞形态学参数相比，细胞质空泡在黑色素瘤诊断中的潜在诊断效用。我们在21例（58%）中发现色素，在28例（78%）中发现浆细胞样细胞，在所有36例（100%）中发现双核/多核、核内细胞质包涵体和显著核仁。细胞质空泡存在于30例（83%）中，且仅在空气干燥的Romanowsky染色涂片中发现。这些发现表明，在黑色素瘤的FNA涂片中，Romanowsky染色涂片中的细胞质空泡具有与黑色素瘤广泛认可的细胞形态学特征相当的患病率和潜在诊断效用。许多文章都聚焦于黑色素瘤FNA诊断的细胞形态学标准，但很少有文章提及黑色素瘤FNA涂片中细胞质空泡的存在，而且罕见的报告表明这一发现是黑色素瘤FNA诊断的一个有用线索。本报告似乎是首个关注黑色素瘤FNA样本中细胞质空泡的患病率和潜在诊断效用的报告。
