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脑膜恶性孤立性纤维性肿瘤/血管外皮细胞瘤的冷冻细胞学检查

Frozen Cytology of Meningeal Malignant Solitary Fibrous Tumor/Hemangiopericytoma.

作者信息

Kang Myunghee, Kim Na Rae, Chung Dong Hae, Yie Gie-Taek

机构信息

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.

出版信息

J Pathol Transl Med. 2019 May;53(3):192-197. doi: 10.4132/jptm.2019.03.20. Epub 2019 Apr 11.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a33a/6527936/778149e1ca21/jptm-2019-03-20f1.jpg

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