Song W, van Hemel B M, Suurmeijer A J H
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, RB Groningen, 9700, The Netherlands.
Diagn Cytopathol. 2018 Apr;46(4):299-305. doi: 10.1002/dc.23887. Epub 2018 Jan 10.
The diagnosis of tumors of soft tissue and bone (STB) heavily relies on histological biopsies, whereas cytology is not widely used. Cellient cell blocks often contain small tissue fragments. In addition to Hematoxylin and Eosin (H&E) interpretation of histological features, immunohistochemistry (IHC) can be applied after optimization of protocols. The objective of this retrospective study was to see whether this cytological technique allowed us to make a precise diagnosis of STB tumors.
Our study cohort consisted of 20 consecutive STB tumors, 9 fine-needle aspiration (FNAC) samples, and 11 endoscopic ultrasonography (EUS) FNACs and included 8 primary tumors and 12 recurrences or metastases of known STB tumors.
In all 20 cases, H&E stained sections revealed that diagnostically relevant histological and cytological features could be examined properly. In the group of 8 primary tumors, IHC performed on Cellient material provided clinically important information in all cases. For instance, gastrointestinal stromal tumor (GIST) was positive for CD117 and DOG-1 and a PEComa showed positive IHC for actin, desmin, and HMB-45. In the group of 12 secondary tumors, SATB2 was visualized in metastatic osteosarcoma, whereas expression of S-100 was present in 2 secondary chondrosarcomas. Metastatic chordoma could be confirmed by brachyury expression. Two metastatic alveolar rhabdomyosarcomas were myf4 positive, a metastasis of a gynecologic leiomyosarcoma was positive for actin and estrogen receptor (ER) and a recurrent dermatofibrosarcoma protuberans expressed CD34.
In the proper clinical context, including clinical presentation with imaging studies, the Cellient cell block technique has great potential for the diagnosis of STB tumors.
软组织和骨肿瘤（STB）的诊断严重依赖组织活检，而细胞学检查尚未广泛应用。Cellient细胞块通常包含小的组织碎片。除苏木精和伊红（H&E）染色用于解读组织学特征外，免疫组织化学（IHC）在优化方案后也可应用。这项回顾性研究的目的是观察这种细胞学技术能否使我们对STB肿瘤做出准确诊断。
我们的研究队列包括20例连续的STB肿瘤、9例细针穿刺抽吸（FNAC）样本和11例内镜超声（EUS）引导下的FNAC样本，包括8例原发性肿瘤以及12例已知STB肿瘤的复发或转移病例。
在所有20例病例中，H&E染色切片显示可对具有诊断意义的组织学和细胞学特征进行恰当检查。在8例原发性肿瘤组中，对Cellient材料进行的IHC在所有病例中均提供了具有临床重要性的信息。例如，胃肠道间质瘤（GIST）对CD117和DOG-1呈阳性，而血管周上皮样细胞瘤（PEComa）对肌动蛋白、结蛋白和HMB-45的IHC呈阳性。在12例继发性肿瘤组中，SATB2在转移性骨肉瘤中可见，而S-100的表达在2例继发性软骨肉瘤中存在。转移性脊索瘤可通过brachyury表达得以证实。2例转移性肺泡横纹肌肉瘤myf4呈阳性，1例妇科平滑肌肉瘤转移灶对肌动蛋白和雌激素受体（ER）呈阳性，1例复发性隆突性皮肤纤维肉瘤表达CD34。
在适当的临床背景下，包括结合影像学检查的临床表现，Cellient细胞块技术在STB肿瘤的诊断方面具有巨大潜力。
