Gardić Nikola, Tomić Sonja, Miljković Dejan, Lovrenski Aleksandra
Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia.
Diagn Cytopathol. 2025 Sep;53(9):E165-E169. doi: 10.1002/dc.25493. Epub 2025 Jun 4.
The cytological characteristics of thymoma are not extensively documented in the literature, primarily due to the tumor's rarity. To our knowledge, there are no standardized criteria for the cytological classification of thymomas.
We report three cases of female patients with cytological smears of thymic epithelial neoplasms, correlating them with the corresponding surgical specimens. In all three smears, the cytological features of the cells were similar and consisted of epithelial and lymphocytic components. Epithelial cells were approximately twice the size of lymphocytes, although some were five times larger, displaying prominent nucleoli and marked nuclear atypia. In many areas of the smears, prominent crush artifacts with chromatin streaking were observed in thymoma cases. The thymic carcinoma case had an inconspicuous crush artifact. The number of lymphocytes varied on the smears. In the smears of thymoma, we had a high number of lymphocytes intermixed with epithelial cells, while in thymic carcinoma, we have just a few scattered lymphocytes. In one case of thymoma, a higher number of mast cells were observed.
Preoperative diagnosis of mediastinal masses is essential for the future clinical management of these patients. As such, cytological diagnosis sometimes plays an important role, although the distinct cytological features of thymic epithelial lesions can be challenging. Our cases suggest specific cytological features that may help differentiate thymoma from thymic carcinoma.
胸腺瘤的细胞学特征在文献中记录并不广泛，主要是因为该肿瘤较为罕见。据我们所知，目前尚无胸腺瘤细胞学分类的标准化标准。
我们报告了3例女性胸腺上皮性肿瘤的细胞学涂片病例，并将其与相应的手术标本进行了对比。在所有3例涂片中，细胞的细胞学特征相似，均由上皮成分和淋巴细胞成分组成。上皮细胞大小约为淋巴细胞的两倍，有些则大五倍，可见明显的核仁及显著的核异型性。在涂片的许多区域，胸腺瘤病例可见明显的挤压伪像及染色质条纹。胸腺癌病例的挤压伪像不明显。涂片上淋巴细胞数量各异。在胸腺瘤涂片中，淋巴细胞数量较多，与上皮细胞混合存在，而在胸腺癌涂片中，仅见少数散在淋巴细胞。在1例胸腺瘤病例中，观察到较多肥大细胞。
纵隔肿块的术前诊断对这些患者未来的临床治疗至关重要。因此，细胞学诊断有时发挥重要作用，尽管胸腺上皮性病变独特的细胞学特征可能具有挑战性。我们的病例提示了一些有助于区分胸腺瘤和胸腺癌的特定细胞学特征。
