Fekete P S, Cohen C, DeRose P B
Department of Pathology, Emory University, Atlanta, Georgia.
Acta Cytol. 1990 Jan-Feb;34(1):50-6.
Six pulmonary spindle cell carcinoids were reviewed. The patients were asymptomatic women ranging from 56 to 76 years of age. Four cases were diagnosed or suspected by percutaneous needle aspiration biopsy. The four patients treated by wedge resection or lobectomy showed no recurrence during the followup period; one patient was followed radiologically without resection for over five years, during which time the lesion remained stable. The cytologic preparations showed groups and single oval or elongated cells that had nuclei with finely granular, evenly dispersed chromatin, usually one small nucleolus and easily disrupted, finely granular cytoplasm. The histologic sections showed circumscribed or infiltrative neoplasms growing as sheets or vaguely organoid cell masses with vascular, focally hyalinized stroma. Immunoreactivity for chromogranin, neuron-specific enolase, synaptophysin, S-100 protein and Leu-7 was typically present; bombesin, serotonin, insulin and calcitonin were focally present in some cases. No reactivity for adrenocorticotropic hormone, somatostatin, gastrin, vasoactive intestinal polypeptide, pancreatic polypeptide, low-molecular-weight cytokeratin (MAK-6) or carcinoembryonic antigen was observed.
回顾了6例肺梭形细胞类癌。患者为56至76岁无症状女性。4例经皮针吸活检确诊或疑似。4例行楔形切除或肺叶切除的患者在随访期间无复发；1例未行切除，接受影像学随访超过5年，在此期间病变保持稳定。细胞学涂片显示细胞呈团状及单个椭圆形或细长形，细胞核有细颗粒状、均匀分布的染色质，通常有一个小核仁，细胞质易破碎、呈细颗粒状。组织学切片显示肿瘤边界清晰或呈浸润性生长，呈片状或模糊的器官样细胞团块，伴有血管，局部有玻璃样变的间质。嗜铬粒蛋白、神经元特异性烯醇化酶、突触素、S-100蛋白和Leu-7通常呈免疫反应阳性；蛙皮素、5-羟色胺、胰岛素和降钙素在某些病例中局部呈阳性。未观察到促肾上腺皮质激素、生长抑素、胃泌素、血管活性肠肽、胰多肽、低分子量细胞角蛋白（MAK-6）或癌胚抗原的反应性。
