Kundu Reetu, Shastri Malvika, Gupta Parikshaa, Gupta Nalini, Srinivasan Radhika, Dey Pranab
Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Cytojournal. 2023 Jun 8;20:14. doi: 10.25259/Cytojournal_30_2022. eCollection 2023.
Carcinosarcomas (CSs) are rare gynecological neoplasms seen in elderly females. These are composed of malignant epithelial and mesenchymal components, which appear as adenocarcinoma and high-grade sarcoma. Effusions are encountered uncommonly in CS.
The study focuses on the cytomorphology of 10 cases of metastatic CS in effusions. In 6 years, there were 10 (0.45%) cases of metastatic CS in effusion samples out of 2240 malignant effusion samples. The samples were processed by SurePath and centrifuge technique. Both May-Grünwald-Giemsa and Papanicolaou stained smears were evaluated for cytomorphological features, and the findings were correlated with subsequent histopathology.
The cells were predominantly arranged in ball-like clusters and discretely. The cells had abundant vacuolated cytoplasm and enlarged pleomorphic nuclei. Occasional cases showed scattered spindle cells. The cases were diagnosed as metastatic adenocarcinoma (7/10) and positive for malignant cells (3/10). None of the cases was diagnosed as CS. The primary of these cases was in the uterus (7/10) and ovary (3/10).
The cytological evaluation of such effusion samples rarely demonstrates the classical biphasic pattern of these tumors. Mostly, the carcinomatous component is evident, and the sarcomatous element is inapparent and readily missed.
癌肉瘤（CSs）是老年女性中罕见的妇科肿瘤。它们由恶性上皮和间充质成分组成，表现为腺癌和高级别肉瘤。癌肉瘤患者出现积液的情况并不常见。
本研究聚焦于10例积液中转移性癌肉瘤的细胞形态学。6年间，在2240份恶性积液样本中，有10例（0.45%）为积液样本中的转移性癌肉瘤。样本采用SurePath和离心技术处理。对May-Grünwald-Giemsa染色涂片和巴氏染色涂片均进行细胞形态学特征评估，并将结果与后续组织病理学结果进行关联。
细胞主要呈球状簇状排列且分散分布。细胞具有丰富的空泡状细胞质和增大的多形性核。偶尔可见散在的梭形细胞。这些病例被诊断为转移性腺癌（7/10），恶性细胞阳性（3/10）。无一例被诊断为癌肉瘤。这些病例的原发部位在子宫（7/10）和卵巢（3/10）。
对此类积液样本进行细胞学评估很少能显示出这些肿瘤典型的双相模式。大多数情况下，癌性成分明显，而肉瘤成分不明显且容易被漏诊。
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