Schwartz J G, Dowd D C
Department of Pathology, University of Texas Health Science Center, San Antonio 78284-7750.
Acta Cytol. 1989 May-Jun;33(3):377-80.
A metastatic malignant schwannoma diagnosed by fine needle aspiration (FNA) biopsy in a 56-year-old man is reported. Cytologic examination of smears and cell blocks prepared from aspirates of a vertebral mass suggested the presence of metastases from a previously excised malignant schwannoma on the right leg. Electron microscopic and immunocytochemical studies on the aspirate supported the diagnosis, as did the patient's clinical history and previous pathology and the radiographic demonstration of metastatic lesions in the lung. The cytologic findings (cells with oval-to-spindled nuclei and ill-defined cellular borders suspended within a delicately fibrillar eosinophilic matrix) are discussed in light of the histologic diversity of this lesion and the problems of distinguishing it from other sarcomas. The ability to diagnose metastatic malignant schwannoma by FNA emphasizes the value of this technique.
报告了1例经细针穿刺（FNA）活检诊断为转移性恶性神经鞘瘤的56岁男性患者。对椎体肿物穿刺涂片及制备的细胞块进行细胞学检查，提示为右下肢先前切除的恶性神经鞘瘤转移灶。对穿刺物进行的电镜和免疫细胞化学研究支持该诊断，患者的临床病史、既往病理检查以及肺部转移灶的影像学表现也支持该诊断。结合该病变的组织学多样性以及与其他肉瘤鉴别诊断的问题，对细胞学表现（细胞核呈椭圆形至梭形、细胞边界不清、悬浮于纤细的嗜酸性纤维基质中的细胞）进行了讨论。通过FNA诊断转移性恶性神经鞘瘤的能力凸显了该技术的价值。
