Ahmed Atif A, Andraws Nevene, Almutairi Ahmed M, Saied Hesham M, Elbagir-Mohamed Asim M
Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
Acta Cytol. 2015;59(4):332-8. doi: 10.1159/000440795. Epub 2015 Oct 1.
Cytospin preparations and immunocytochemistry are common methods in hospitals to evaluate malignancies in body fluids. Characteristics of malignant cells in pediatric body fluids have not been adequately evaluated.
183 pleural, peritoneal and pericardial pediatric fluid specimens were examined by cytospin preparations and immunocytochemistry from two hospitals using similar procedural techniques. Cytologic diagnoses were correlated with the results of clinical history, histology and ancillary studies.
Forty cases with malignancy were identified (21.9%); the most common diagnoses were rhabdomyosarcoma and acute lymphoblastic lymphoma (9 and 8 cases, respectively). Small round cell tumors revealed similar morphology as clusters of small round cells with central nuclei and scant cytoplasm with frequent small vacuoles. Twenty-one cases were evaluated by immunocytochemistry, 12 by flow cytometry and 5 by cytogenetic analysis. CD3, CD20, TdT, CD10, desmin and myogenin were the most common markers. Staining artifacts causing interpretation difficulties were noted in 5 cases that were resolved by molecular studies and deferral for surgical specimens.
Small round cell tumors are the most common malignancies encountered in pediatric body fluids and share a nonspecific morphology. Although immunocytochemistry is helpful to arrive at the correct diagnosis, other ancillary studies may be necessary, particularly in hematologic malignancies and other difficult cases.
甩片制备和免疫细胞化学是医院评估体液恶性肿瘤的常用方法。儿科体液中恶性细胞的特征尚未得到充分评估。
使用相似的操作技术，通过甩片制备和免疫细胞化学对来自两家医院的183份儿科胸膜、腹膜和心包积液标本进行检查。细胞学诊断与临床病史、组织学和辅助检查结果相关。
确诊40例恶性肿瘤（21.9%）；最常见的诊断是横纹肌肉瘤和急性淋巴细胞白血病（分别为9例和8例）。小圆细胞肿瘤表现出相似的形态，即中央有核、胞质稀少且常有小空泡的小圆细胞簇。21例通过免疫细胞化学评估，12例通过流式细胞术评估，5例通过细胞遗传学分析评估。CD3、CD20、TdT、CD10、结蛋白和肌细胞生成素是最常用的标志物。5例出现导致解读困难的染色假象，通过分子研究和推迟手术标本检查得以解决。
小圆细胞肿瘤是儿科体液中最常见的恶性肿瘤，具有非特异性形态。尽管免疫细胞化学有助于做出正确诊断，但可能还需要其他辅助检查，尤其是在血液系统恶性肿瘤和其他疑难病例中。
