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睑部病变的细胞学评估:借助组织病理学确证洞察其局限性

Cytological Evaluation of Palpebral Lesions: An Insight into its Limitations Aided with Histopathological Corroboration.

作者信息

Mondal Krishnendu, Mandal Rupali, Chakrabarti Indranil

机构信息

Department of Pathology, North Bengal Medical College and Hospital, Siliguri, West Bengal, India.

出版信息

J Microsc Ultrastruct. 2020 Nov 9;9(1):12-17. doi: 10.4103/JMAU.JMAU_58_19. eCollection 2021 Jan-Mar.

Abstract

CONTEXT

Eyelids by virtue of its unique histomorphology give rise to multitudes of different pathological conditions. Appropriate preoperative cytological diagnoses of these cases are necessary to determine their optimal therapy.

AIMS

The aims of this study were to evaluate the utility of various cytological techniques in diagnosing the definite pathology for palpebral lesions and thereby to highlight the drawbacks associated with cytology in this context.

MATERIALS AND METHODS

Fine-needle cytology with or without applying the aspiration was the preferable method. Ulcerated lesions were sampled through scrapings.

RESULTS

Totally 62 cases were examined. Cytologically, 22 lesions were diagnosed as nonneoplastic, 38 lesions were neoplastic, and nondiagnostic material was obtained twice. Malignant tumors predominated among the neoplastic cases. Basal cell carcinoma (BCC) was the most common malignancy observed. On histopathological corroboration, benign skin adnexal tumor was found to be the most frequently misinterpreted entity. Two (out of four cases) of those tumors were confirmed as melanocytic nevus and BCC. A single case of squamous cell carcinoma was also cytodiagnostically erred into sebaceous carcinoma.

CONCLUSIONS

Cytologically palpebral pathologies, including the neoplastic ones, are at times vulnerable to misinterpretation. To avert such dilemma, it is better to readily excise any recurrent lesion, basaloid neoplasm, or any necrohemorrhagic lesion presumptive of overshadowing the neoplastic pathology underneath.

摘要

背景

眼睑因其独特的组织形态学特征会引发多种不同的病理状况。对这些病例进行恰当的术前细胞学诊断对于确定最佳治疗方案至关重要。

目的

本研究的目的是评估各种细胞学技术在诊断睑部病变明确病理方面的效用,从而突出在此背景下细胞学相关的缺点。

材料与方法

采用有或无抽吸的细针细胞学检查是较为可取的方法。对溃疡性病变通过刮片取样。

结果

共检查了62例病例。细胞学检查显示,22例病变被诊断为非肿瘤性,38例病变为肿瘤性,有两次获取到无法诊断的材料。肿瘤性病例中恶性肿瘤占主导。基底细胞癌(BCC)是观察到的最常见恶性肿瘤。经组织病理学证实,良性皮肤附属器肿瘤是最常被误诊的实体。其中四例肿瘤中有两例被确认为黑素细胞痣和基底细胞癌。一例鳞状细胞癌在细胞诊断时也被误诊为皮脂腺癌。

结论

在细胞学上,睑部病变,包括肿瘤性病变,有时容易被误诊。为避免这种困境,最好对任何复发性病变、基底样肿瘤或任何可能掩盖其下肿瘤性病理的坏死出血性病变立即进行切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/8030541/ef9eded0dccb/JMAU-9-12-g001.jpg

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