Pillai K R, Kannan S, Gangadharan V P, Abraham E K, Chandralekha B, Pillai G R, Amma N S, Nair M K
Division of Cytopathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Neoplasma. 1993;40(3):193-7.
A rare case of germ cell tumor of the mediastinum infiltrating the lung and metastasizing to the supraclavicular lymph node in a 25-year-old male is presented. The patient presented with a history of superior vena cava syndrome and chest roentgenograms revealed an abnormal mediastinum. Primary positive diagnosis was made cytologically on sputum specimens. The peculiar cell type found in the Papanicolaou stained sputum smears were correlated with fine needle aspiration cytology of lung and lymph node, and confirmed the histologic pattern of the tumor metastasizing to the lymph node. To our knowledge, the present case is the first report of a primary mediastinal seminoma (germinoma) infiltrating the lung and diagnosed by sputum cytology. These results suggest the usefulness of sputum examination as an adjunctive diagnostic procedure in the detection of patients with possible lung infiltrated germinal neoplasms.
本文报告了一例罕见的纵隔生殖细胞瘤，该肿瘤侵犯肺部并转移至一名25岁男性的锁骨上淋巴结。患者有上腔静脉综合征病史，胸部X线片显示纵隔异常。通过痰液标本进行细胞学检查做出了初步阳性诊断。巴氏染色痰液涂片发现的特殊细胞类型与肺和淋巴结的细针穿刺细胞学检查结果相关，证实了肿瘤转移至淋巴结的组织学模式。据我们所知，本病例是首例经痰液细胞学检查诊断出的原发性纵隔精原细胞瘤（生殖细胞瘤）侵犯肺部的报告。这些结果表明，痰液检查作为一种辅助诊断方法，对于检测可能存在肺部浸润性生殖细胞瘤的患者具有重要价值。
