Singh Anshima, Rao Ram Nawal
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
J Cytol. 2024 Oct-Dec;41(4):214-220. doi: 10.4103/joc.joc_201_23. Epub 2024 Nov 8.
Chordomas are rare notochordal tumors. They are suitable candidates for squash smear cytology (SSC) owing to their gelatinous consistency and destructive nature. SSC is an important tool for making a quick intra-operative preliminary diagnosis and taking real-time surgical and further management decisions. This study aimed to evaluate the diagnostic accuracy of SSC for chordoma cases.
This retrospective study conducted in a North Indian tertiary care center enrolled chordoma cases histopathologically diagnosed between 01.01.2013 and 31.07.2023, for which SSC was also performed. SSC smears and their corresponding histopathology slides (±immunohistochemistry [IHC] slides) were retrieved. Histo-cytological correlation was performed.
In total, 13 such cases were retrieved. The mean age was 34.4 + 5.6 years. The male-female ratio was 1:1.6. The most common location was the spheno-occipital region (10 cases), followed by sacro-coccygeal (two cases) and vertebral regions (1 case). The SSC was positive for chordoma in 10/13 cases. Thus, the calculated accuracy of SSC in chordoma diagnosis was 76.9%. A total of 3/13 (23.1%) cases where SSC was inconclusive for chordoma were difficult to diagnose cases, requiring IHC for ultimate diagnosis. Cytological features such as abundant myxoid matrix and physaliphorous cells help in correct diagnosis of chordoma on SSC.
We found the diagnostic accuracy of SSC in chordoma diagnosis to be 76.9%. Features such as abundant myxoid matrix and physaliphorous cells are helpful in correct diagnosis on SSC. Thus, even though chordomas are rare, one should consider them among the differential diagnoses in cases presenting with appropriate clinico-radiological features and characteristic cytological findings.
脊索瘤是罕见的脊索肿瘤。由于其胶冻样质地和破坏性本质，它们是压片细胞学检查（SSC）的合适对象。SSC是进行术中快速初步诊断以及做出实时手术和进一步治疗决策的重要工具。本研究旨在评估SSC对脊索瘤病例的诊断准确性。
这项回顾性研究在印度北部的一家三级医疗中心开展，纳入了2013年1月1日至2023年7月31日期间经组织病理学诊断为脊索瘤且也进行了SSC的病例。检索了SSC涂片及其相应的组织病理学切片（±免疫组织化学[IHC]切片）。进行了组织细胞学相关性分析。
总共检索到13例此类病例。平均年龄为34.4±5.6岁。男女比例为1:1.6。最常见的部位是蝶枕区（10例），其次是骶尾区（2例）和椎体区（1例）。13例中有10例SSC对脊索瘤呈阳性。因此，计算得出SSC在脊索瘤诊断中的准确性为76.9%。在13例中有3例（23.1%）SSC对脊索瘤诊断不明确，这些病例诊断困难，需要IHC进行最终诊断。丰富的黏液样基质和泡状核细胞等细胞学特征有助于在SSC上正确诊断脊索瘤。
我们发现SSC在脊索瘤诊断中的准确性为76.9%。丰富的黏液样基质和泡状核细胞等特征有助于在SSC上做出正确诊断。因此，尽管脊索瘤罕见，但在具有适当临床放射学特征和特征性细胞学表现的病例中，应将其纳入鉴别诊断。
