Maciejewski Joshua, Hasteh Farnaz, Patel Charmi, Pezhouh Maryam, Hu Jingjing
Department of Pathology, University of California San Diego, San Diego, California, USA.
Diagn Cytopathol. 2025 Nov;53(11):E215-E220. doi: 10.1002/dc.70010. Epub 2025 Aug 18.
Fine-needle aspiration (FNA) or core needle biopsy via EBUS procedure is commonly used to assess suspicious lung nodules. Alveolar macrophages are commonly seen in these specimens. In cases when hypercellular specimens with large aggregates of alveolar macrophages are encountered, especially when they show epithelioid morphology, vacuolated cytoplasm, and significant cytological atypia, including marked anisonucleosis and intracytoplasmic inclusion, they can be mistakenly interpreted as "lesional cells" during rapid on-site evaluation (ROSE) and cease the EBUS procedure prematurely. It is important to keep in mind that epithelioid alveolar macrophages may mimic lung neuroendocrine tumor (NET), lung adenocarcinoma, or even metastatic process. Cytoplasmic pigmentation and immunohistochemistry analysis can be extremely useful to prevent a false diagnosis of malignancy.
通过超声支气管镜引导下细针穿刺抽吸术（FNA）或粗针活检常用于评估可疑肺结节。在这些标本中常见肺泡巨噬细胞。当遇到含有大量肺泡巨噬细胞聚集的细胞丰富标本时，尤其是当它们表现出上皮样形态、空泡状细胞质和明显的细胞学异型性，包括显著的核大小不均和胞质内包涵体时，在快速现场评估（ROSE）过程中它们可能会被错误地解释为“病变细胞”，从而过早终止超声支气管镜检查程序。重要的是要记住，上皮样肺泡巨噬细胞可能会模仿肺神经内分泌肿瘤（NET）、肺腺癌，甚至转移过程。细胞质色素沉着和免疫组织化学分析对于防止恶性肿瘤的误诊非常有用。
