Silverman J F, Joshi V V
Department of Pathology and Laboratory Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354.
Diagn Cytopathol. 1994;10(3):245-55. doi: 10.1002/dc.2840100312.
Pediatric tumors which are conventionally considered to be small round cell tumors (SRCTs) include the prototypical neuroblastoma as well as rhabdomyosarcoma (RMS), Ewing's sarcoma (ES), malignant lymphoma, and primitive neuroectodermal tumor (PNET). Other malignancies may be considered in the differential diagnosis such as small-cell osteogenic sarcoma, undifferentiated (anaplastic) hepatoblastoma, granulocytic sarcoma, blastemal type Wilms' tumor, and desmoplastic small-cell tumor of the peritoneum. The cytomorphologic features of conventional SRCTs is presented as well as the utility of ancillary studies performed on the aspirated material in making a specific and correct diagnosis. The role of the immediate cytologic assessment of the aspirate is stress, since this is a critical step in formulating an initial diagnostic impression that should prompt the need for additional material for pertinent ancillary studies. Although challenging, FNA cytology of SRCTs of childhood can be diagnostic in the majority of cases, allowing specific therapy to be given to patients with unresectable SRCTs without a tissue biopsy as well as documenting recurrent and/or metastatic disease.
传统上被认为是小圆细胞肿瘤（SRCT）的儿科肿瘤包括典型的神经母细胞瘤以及横纹肌肉瘤（RMS）、尤因肉瘤（ES）、恶性淋巴瘤和原始神经外胚层肿瘤（PNET）。鉴别诊断中可能还需考虑其他恶性肿瘤，如小细胞骨肉瘤、未分化（间变性）肝母细胞瘤、粒细胞肉瘤、胚芽型肾母细胞瘤以及腹膜促纤维组织增生性小细胞瘤。本文介绍了传统SRCT的细胞形态学特征，以及对抽吸物进行辅助检查在做出准确诊断方面的作用。强调了对抽吸物进行即时细胞学评估的作用，因为这是形成初步诊断印象的关键步骤，应促使获取更多材料进行相关辅助检查。虽然具有挑战性，但儿童SRCT的细针穿刺抽吸活检（FNA）细胞学检查在大多数情况下可做出诊断，使无法切除的SRCT患者无需组织活检即可接受特异性治疗，并可记录复发和/或转移性疾病。
