Kwon Ah-Young, Han Joungho, Cho Hae-Yon, Kim Seokhwi, Bang Heejin, Hyeon Jiyeon
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Pathol Transl Med. 2017 Sep;51(5):509-512. doi: 10.4132/jptm.2017.03.22. Epub 2017 Aug 4.
Thymic adenocarcinoma is extremely rare. Although its histologic features have been occasionally reported, a lack of description of the cytologic features has hampered the prompt and accurate diagnosis of this condition. Herein, we describe the cytologic findings and histology of four aspiration cytology specimens of thymic adenocarcinoma. The specimens were obtained from primary tumors, metastatic lymph nodes, and pericardial effusions. All four specimens showed three-dimensional glandular clusters with a loss of polarity and nuclear overlapping. One specimen had extensive extracellular mucinous material. Three specimens contained tumor cells with intracytoplasmic vacuoles. While the specimen with extracellular mucin showed relatively mild cytologic atypia, other specimens exhibited more atypical cytologic changes: irregular nuclear membranes, a coarse chromatin pattern, and prominent nucleoli. The cytologic features were correlated with the histologic features in each case of enteric type thymic adenocarcinoma. The differential diagnosis included other thymic carcinomas, yolk sac tumors, and metastatic adenocarcinoma from the lung or colorectum.
胸腺癌极为罕见。尽管其组织学特征偶尔有报道，但缺乏对细胞学特征的描述阻碍了对该疾病的快速准确诊断。在此，我们描述了4例胸腺癌穿刺细胞学标本的细胞学发现及组织学特征。标本取自原发性肿瘤、转移性淋巴结及心包积液。所有4例标本均显示三维腺管簇，极性丧失且核重叠。1例标本有大量细胞外黏液物质。3例标本含有胞质内有空泡的肿瘤细胞。有细胞外黏液的标本细胞学异型性相对较轻，而其他标本则表现出更明显的异型细胞学改变：核膜不规则、染色质粗糙及核仁显著。在每例肠型胸腺癌中，细胞学特征与组织学特征相关。鉴别诊断包括其他胸腺癌、卵黄囊瘤以及来自肺或结肠直肠的转移性腺癌。
