Dept of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 2.216, Houston, TX 77030; e-mail:
Am J Clin Pathol. 2013 Oct;140(4):454-67. doi: 10.1309/AJCPHDOVGW64FIPB.
The field of cytopathology has been rapidly advancing in the era of molecular pathology and personalized medicine. On-site cytologic evaluation for adequacy and triaging specimens for small core biopsy or fine-needle aspiration (FNA) are often required. Cytopathologists face the challenge of how to best triage small specimens for diagnosis, molecular testing, and personalized treatment. Owing to its minimally invasive nature, FNA alone or combined with core biopsy for lymphoproliferative disorders and soft tissue tumors has gained popularity.
Literature review and author's institutional experience are used for this review article. This article will focus mainly on lymphoproliferative disorders and soft tissue tumors.
Evaluation combining cytomorphology, immunohistochemistry, and/or molecular pathology is often needed to accurately diagnose and classify lymphomas and soft tissue tumors. Many molecular tests have been performed on cytologic specimens, such as tests for BRAF and RET in thyroid FNA.
Molecular pathology has been widely integrated into conventional cytopathology for diagnosing lymphoproliferative disorders and soft tissue tumors, and the diagnostic value of FNA on those tumors has increased significantly. Cytology will play a more important role in the era of personalized medicine.
在分子病理学和个性化医学时代，细胞病理学领域发展迅速。通常需要现场细胞学评估以确定标本是否充足，并对小核心活检或细针抽吸 (FNA) 标本进行分类。细胞病理学家面临着如何最好地对小标本进行诊断、分子检测和个性化治疗分类的挑战。由于其微创性质，FNA 单独或与核心活检联合用于治疗淋巴增生性疾病和软组织肿瘤已变得流行。
本文采用文献回顾和作者所在机构的经验。本文将主要关注淋巴增生性疾病和软组织肿瘤。
为了准确诊断和分类淋巴瘤和软组织肿瘤，通常需要结合细胞形态学、免疫组织化学和/或分子病理学进行评估。许多分子检测已在细胞学标本上进行，例如甲状腺 FNA 中的 BRAF 和 RET 检测。
分子病理学已广泛整合到常规细胞病理学中，用于诊断淋巴增生性疾病和软组织肿瘤，FNA 对这些肿瘤的诊断价值显著提高。细胞病理学在个性化医学时代将发挥更重要的作用。
