Tao L C, Weisbrod G, Ritcey E L, Ilves R
Acta Cytol. 1984 Jul-Aug;28(4):450-6.
With the introduction of transbronchial brushings and fine needle aspiration biopsy, which enable us to obtain samples directly from lesions, the diagnostic potential of cytology for the detection of malignancy, including early cancer, has been greatly enhanced. From 1976 to 1982, five positive cytology reports were initially considered to be "false positives" on the basis of negative gross findings, benign operative biopsies or negative histologic findings in the resected surgical specimens. However, these proved to be false "false positives," based upon the clinical follow-up or further examination of the surgical specimens. Presentation is made of three of these cases with positive cytologic findings and initially negative histologic diagnoses, with an analysis of the causes of the latter. From our experience, four types of cancerous lesions seem prone to being missed during gross examination, namely: any small cancer with a consistency similar to that of the parenchyma of the organ in which the tumor is located, superficially invasive carcinoma, scar cancer and a radiologically occult lung cancer in the presence of a coexisting radiologically demonstrable lesion. With more clinical application of these cytologic methods, false "false positives" are expected to occur more often.
随着经支气管刷检和细针穿刺活检技术的引入，使我们能够直接从病变部位获取样本，细胞学检查在检测包括早期癌症在内的恶性肿瘤方面的诊断潜力得到了极大提高。1976年至1982年期间，最初有5份细胞学阳性报告，基于大体检查阴性、良性手术活检或切除手术标本的组织学阴性结果，被认为是“假阳性”。然而，根据临床随访或对手术标本的进一步检查，这些结果被证明是假的“假阳性”。本文介绍了其中3例细胞学检查结果阳性但最初组织学诊断为阴性的病例，并分析了后者的原因。根据我们的经验，在大体检查过程中，有4种类型的癌性病变似乎容易被漏诊，即：任何质地与肿瘤所在器官实质相似的小癌、浅表浸润性癌、瘢痕癌以及在存在可通过影像学显示的病变时的影像学隐匿性肺癌。随着这些细胞学方法在临床上的更多应用，预计假的“假阳性”情况会更频繁地出现。
