Kumar R, Bharani V, Gupta N, Gupta K, Dey P, Srinivasan R, Rajwanshi A
Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cytopathology. 2018 Jun;29(3):288-293. doi: 10.1111/cyt.12533. Epub 2018 Mar 25.
Cytology of giant cell tumour of tendon sheath (GCTTS) is often sufficient to diagnose this lesion and has been previously described in small series. The present study was undertaken to evaluate detailed cytomorphological features and differential diagnostic entities and pitfalls in the diagnosis.
All the cases of GCTTS reported on FNAC were retrieved from July 2007 to June 2017. The cases were reviewed for various cytomorphological features, which were correlated with follow-up histopathology wherever available.
A total of 72 cases of GCTTS were retrieved, follow-up histopathology was available in 20 cases. The common sites of involvement were fingers and palm followed by wrists, elbow, knee, ankle and shoulder. The characteristic cytomorphology consisted of mononuclear cells, multinucleated giant cells and pigment laden macrophages in variable numbers. There were four discordant cases that were confirmed on histopathology as sarcoidosis, melanoma, fibrous histiocytoma and eumycetoma.
GCTTS can be confused cytologically with giant cell rich lesions of bone and soft tissue and pigment containing lesions including melanoma. Ladybird cell is a characteristic feature seen in this lesion. Proper clinicoradiological correlation is essential before offering a diagnosis of GCTTS on cytology.
腱鞘巨细胞瘤（GCTTS）的细胞学检查通常足以诊断该病变，此前已有小样本研究报道。本研究旨在评估其详细的细胞形态学特征、鉴别诊断实体以及诊断中的陷阱。
检索2007年7月至2017年6月间所有经细针穿刺抽吸活检（FNAC）报告的GCTTS病例。对这些病例的各种细胞形态学特征进行回顾，并尽可能与随访组织病理学结果进行关联。
共检索到72例GCTTS病例，其中20例有随访组织病理学结果。常见受累部位为手指和手掌，其次是手腕、肘部、膝盖、脚踝和肩部。特征性细胞形态包括数量不等的单核细胞、多核巨细胞和含色素巨噬细胞。有4例不一致病例，经组织病理学确诊为结节病、黑色素瘤、纤维组织细胞瘤和足菌肿。
GCTTS在细胞学上可能与富含巨细胞的骨和软组织病变以及含色素病变（包括黑色素瘤）相混淆。瓢虫样细胞是该病变的特征性表现。在通过细胞学诊断GCTTS之前，进行恰当的临床与放射学关联至关重要。
