Akerman M, Rydholm A
Department of Cytodiagnostics, University Hospital, Lund, Sweden.
Diagn Cytopathol. 1987 Dec;3(4):295-302. doi: 10.1002/dc.2840030407.
The cytodiagnoses of preoperative fine-needle aspirate smears from 72 histologically proven lipomatous tumors (52 lipomas and 20 liposarcomas of varying type) collected during the 10-yr period 1972-1981 were correlated to the corresponding histopathologic diagnoses. Three out of 52 lipomas were erroneously diagnosed as low-grade malignant liposarcomas, and one out of 20 liposarcomas was falsely diagnosed as a benign soft-tissue tumor. Of the 20 liposarcomas, 15 were cytologically diagnosed as such, and the majority of the myxoid and the pleomorphic liposarcomas were correctly diagnosed as to type. Important differential diagnostic problems were, on one hand, the separation of lipoma with regressive changes and histiocytic reaction and lipoma with chondroid metaplasia from low-grade malignant liposarcoma and, on the other hand, liposarcoma from intramuscular myxoma, myxofibrosarcoma, and malignant fibrous histiocytoma. The differential diagnosis of liposarcoma as opposed to other soft-tissue sarcomas is discussed, and it is concluded that preoperative fine-needle aspiration of lipomatous tumors is of value in the management of these tumors.
对1972年至1981年这10年间收集的72例经组织学证实的脂肪瘤性肿瘤（52例脂肪瘤和20例不同类型的脂肪肉瘤）术前细针穿刺涂片进行细胞诊断，并与相应的组织病理学诊断进行关联。52例脂肪瘤中有3例被错误诊断为低级别恶性脂肪肉瘤，20例脂肪肉瘤中有1例被错误诊断为良性软组织肿瘤。在20例脂肪肉瘤中，15例经细胞学诊断为此类，黏液样和多形性脂肪肉瘤的大多数类型被正确诊断。重要的鉴别诊断问题一方面是将有退行性改变和组织细胞反应的脂肪瘤以及有软骨化生的脂肪瘤与低级别恶性脂肪肉瘤区分开来，另一方面是将脂肪肉瘤与肌内黏液瘤、黏液纤维肉瘤和恶性纤维组织细胞瘤区分开来。讨论了脂肪肉瘤与其他软组织肉瘤的鉴别诊断，得出结论：脂肪瘤性肿瘤的术前细针穿刺在这些肿瘤的管理中具有价值。
