Becker S N, Sass M A, Petras R E, Hart W R
Acta Cytol. 1986 Jul-Aug;30(4):347-50.
Hepatic arterial infusion chemotherapy (HAIC) for unresectable hepatic neoplasms has been associated with gastric ulcers and epithelial atypia that may be misinterpreted as carcinoma. Gastric brushings were reviewed from six patients who developed gastric ulcers with histologically proven atypia following HAIC. Marked cytologic atypia, reminiscent of a pronounced radiation effect, was present in gastric epithelial cells in five patients. The atypical cells occurred singly or in small sheets. They were markedly enlarged but a low nuclear-cytoplasmic ratio was preserved. The abundant cytoplasm was vacuolated or foamy. Binucleation and multinucleation were common, and massive nucleoli were characteristic. The brushings also contained the reparative, inflammatory and necrotic changes associated with usual benign gastric ulcers. The bizarre atypia associated with HAIC can be a source of misdiagnosis of cancer in cytologic as well as in histologic specimens.
肝动脉灌注化疗（HAIC）用于不可切除的肝脏肿瘤时，与胃溃疡和上皮异型增生有关，后者可能被误诊为癌。对6例HAIC后发生胃溃疡且组织学证实有异型增生的患者的胃刷检标本进行了回顾性分析。5例患者的胃上皮细胞出现明显的细胞学异型性，类似于明显的放射效应。异型细胞单个或呈小片状出现。它们明显增大，但核质比保持较低。丰富的细胞质呈空泡状或泡沫状。双核和多核很常见，且有大量核仁是其特征。刷检标本中还存在与普通良性胃溃疡相关的修复、炎症和坏死改变。与HAIC相关的奇异异型增生在细胞学和组织学标本中都可能是癌症误诊的来源。
