Gupta R K, Delahunt B, alAnsari A G
Department of Cytology, Wellington Hospital and School of Medicine, New Zealand.
Acta Cytol. 1995 May-Jun;39(3):499-502.
Needle aspiration cytology of an undiagnosed retroperitoneal mass was performed on a 37-year-old male. The cytologic findings were highly consistent with a seminoma. In the differential diagnosis the possibility of non-Hodgkin's lymphoma, melanocarcinoma and metastatic adenocarcinoma was considered. The cytologic features in the aspirate included uniform, single to loose groups of malignant cells with round nuclei and prominent nucleoli and pale cytoplasm with occasional vacuoles. A variable number of lymphocytes were intermingled with the neoplastic cells. On immunostaining, the markers for lymphoma, melanoma and epithelial malignancy were negative, while alpha-1-antitrypsin was positive in malignant cells, and alkaline phosphatase activity was weakly positive in the cytoplasm. In view of the cytologic diagnosis, a clinical examination of the testes was undertaken and followed by an ultrasound examination, which demonstrated a well-demarcated tumor in the left testis. It was removed and diagnosed as a typical seminoma. This case is of interest since needle aspiration cytodiagnosis not only suggested the correct diagnosis in an otherwise-undiagnosed retroperitoneal mass but also led to a timely investigation and correct management.
对一名37岁男性的未确诊腹膜后肿块进行了针吸细胞学检查。细胞学检查结果与精原细胞瘤高度一致。在鉴别诊断中，考虑了非霍奇金淋巴瘤、黑色素癌和转移性腺癌的可能性。吸出物中的细胞学特征包括均匀的、单个至松散聚集的恶性细胞，细胞核圆形，核仁突出，细胞质淡染，偶尔有空泡。不同数量的淋巴细胞与肿瘤细胞混合。免疫染色显示，淋巴瘤、黑色素瘤和上皮恶性肿瘤的标志物均为阴性，而α-1-抗胰蛋白酶在恶性细胞中呈阳性，碱性磷酸酶活性在细胞质中呈弱阳性。鉴于细胞学诊断，对睾丸进行了临床检查，随后进行了超声检查，结果显示左侧睾丸有一个边界清晰的肿瘤。该肿瘤被切除并诊断为典型的精原细胞瘤。这个病例很有意思，因为针吸细胞诊断不仅在未确诊的腹膜后肿块中提示了正确的诊断，还导致了及时的检查和正确的处理。
