Kundu Uma, Gan Qiong, Donthi Deepak, Sneige Nour
Section of Cytopathology, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Diagnostics (Basel). 2023 Jul 18;13(14):2400. doi: 10.3390/diagnostics13142400.
Fine needle aspiration is a minimally invasive, low-morbidity, and cost-efficient technique for the sampling of mediastinal lesions. Additionally, ancillary testing on FNA samples can be used for the refinement of diagnoses and for treatment-related purposes (flow cytometry, cytogenetics, immunohistochemistry, and molecular diagnostics). Mediastinal lesions, however, can show a variety of lineages and morphologic features, giving rise to diagnostic dilemmas. As a result, the differential diagnosis can vary widely and becomes especially challenging due to the smaller sample size on FNA and the variability in component sampling. For appropriate patient management and to determine the correct treatment strategies, accurate pathologic diagnoses are paramount. In this review, we present the cytomorphologic features together with the immunophenotypic findings of mediastinal lesions, with emphasis on the diagnostic challenges and pitfalls in FNA cytology samples, including smears and cell block sections.
细针穿刺抽吸是一种用于纵隔病变采样的微创、低发病率且成本效益高的技术。此外，对细针穿刺抽吸样本进行辅助检测可用于完善诊断及治疗相关目的（流式细胞术、细胞遗传学、免疫组织化学和分子诊断）。然而，纵隔病变可表现出多种谱系和形态学特征，从而导致诊断难题。因此，鉴别诊断范围可能很广，并且由于细针穿刺抽吸样本量较小以及成分采样的变异性，使得鉴别诊断极具挑战性。为了进行适当的患者管理并确定正确的治疗策略，准确的病理诊断至关重要。在本综述中，我们展示了纵隔病变的细胞形态学特征以及免疫表型结果，重点关注细针穿刺抽吸细胞学样本（包括涂片和细胞块切片）中的诊断挑战和陷阱。
