Wakely P E, Frable W J
Department of Pathology, Virginia Commonwealth University/Medical College of Virginia, Richmond 23298.
Am J Clin Pathol. 1994 Jul;102(1):87-90. doi: 10.1093/ajcp/102.1.87.
Localized nodular tenosynovitis, better known as giant-cell tumor of tendon sheath (GCTTS), is a common neoplasm that has a peak incidence in the fourth to sixth decades of life. Few reports exist elucidating the cytologic features of this lesion obtained by fine-needle aspiration biopsy (FNAB). The authors describe five patients, aged 8-50 years, in whom GCTTS was diagnosed by FNAB cytology. In four of the patients, the lesion was excised, and the FNAB diagnosis of GCTTS was confirmed; surgical excision is pending in one patient. A diagnosis of malignancy was not suggested in any of the patients. The tumors were .7-5 cm in greatest dimension. In two patients, GCTTS affected the ankle; the hand was affected in the other three. Aspiration smears were cellular in four cases. All but one case contained several multinucleate osteoclast-type giant cells; in addition, binucleate cells were common. The nongiant cell population was dispersed principally as single cells that had a cytologic appearance mimicking histiocytes and osteoblasts. Anisonucleosis was minimal, and nuclear pleomorphism was distinctly absent in both single and multinucleate cells. Mitotic figures were infrequent, except in one case. The diagnosis of GCTTS can be made or at least strongly suggested using FNAB when the cytologic and clinical features are combined.
局限性结节性腱鞘炎，更常见的名称是腱鞘巨细胞瘤（GCTTS），是一种常见的肿瘤，在40至60岁发病率最高。很少有报告阐明通过细针穿刺活检（FNAB）获得的该病变的细胞学特征。作者描述了5例年龄在8至50岁的患者，通过FNAB细胞学诊断为GCTTS。其中4例患者的病变被切除，FNAB诊断为GCTTS得到证实；1例患者有待手术切除。所有患者均未提示恶性诊断。肿瘤最大直径为0.7至5厘米。2例患者GCTTS累及踝关节；另外3例累及手部。4例患者的穿刺涂片细胞丰富。除1例病例外，所有病例均含有数个多核破骨细胞型巨细胞；此外，双核细胞也很常见。非巨细胞群体主要以单个细胞分散存在，其细胞学外观类似组织细胞和成骨细胞。核大小不一不明显，单核和多核细胞均明显无核多形性。除1例病例外，有丝分裂象罕见。当结合细胞学和临床特征时，使用FNAB可以做出GCTTS的诊断，或至少强烈提示该诊断。
