Kang Myunghee, Kim Na Rae, Chung Dong Hae, Yie Gie-Taek
Department of Pathology Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
J Pathol Transl Med. 2019 May;53(3):192-197. doi: 10.4132/jptm.2019.03.20. Epub 2019 Apr 11.
A 51-year-old woman presented with severe dizziness. The brain magnetic resonance image revealed a 5.5 cm multiloculated mass with a thick rim in the left temporal lobe. Cytological examination of frozen diagnosis of the mass showed hypercellular sheets of round and rhabdoid cells in a hemorrhagic background, and two mitotic figures were observed. Histologically, the excised dura-based mass consisted of predominantly round cells with small foci of rhabdoid tumor cells in a pseudoalveolar pattern in a hemorrhagic background, and the cells showed nuclear positivity for signal transducer and activator of transcription 6 as well as frequent mitosis. The mass was diagnosed as a grade 3 solitary fibrous tumor (SFT)/hemangiopericytoma (HPC). The cytological diagnosis of SFT/HPC is challenging because of the heterogeneous cytological findings, such as histological heterogeneity, and because there are no standardized cytological criteria for malignant SFT/HPC. Cytological findings, such as singly scattered small cells, hypercellularity, rare ropy collagen, and round and rhabdoid cells with pseudoalveolar pattern, may assist in the diagnosis of malignant SFT/HPC.
一名51岁女性因严重头晕就诊。脑部磁共振成像显示左颞叶有一个5.5厘米的多房性肿块，边缘较厚。对该肿块进行冷冻诊断的细胞学检查显示，在出血背景中有圆形和横纹肌样细胞组成的细胞增多片层，观察到两个有丝分裂象。组织学上，切除的硬膜下肿块主要由圆形细胞组成，在出血背景中可见小灶性横纹肌样肿瘤细胞呈假腺泡样排列，细胞显示信号转导和转录激活因子6核阳性以及频繁有丝分裂。该肿块被诊断为3级孤立性纤维瘤（SFT）/血管外皮细胞瘤（HPC）。由于细胞学表现存在异质性，如组织学异质性，且恶性SFT/HPC没有标准化的细胞学标准，因此SFT/HPC的细胞学诊断具有挑战性。细胞学表现，如单个散在的小细胞、细胞增多、罕见的索状胶原以及呈假腺泡样排列的圆形和横纹肌样细胞，可能有助于恶性SFT/HPC的诊断。
