Powers C N, Silverman J F, Geisinger K R, Frable W J
Department of Pathology, SUNY Health Science Center 13210, USA.
Am J Clin Pathol. 1996 Feb;105(2):168-73. doi: 10.1093/ajcp/105.2.168.
The combined experience of four university medical centers with fine-needle aspiration biopsy (FNAB) of the mediastinum is reviewed. This series includes 189 cases, with 100 males and 89 females, 6 months to 86 years of age. The majority (71%) of diagnoses were neoplastic with the remainder equally distributed between nondiagnostic/unsatisfactory and nonneoplastic lesions. Malignant lymphoma and thymoma were the most frequent primary malignancies. Metastatic tumors represented the majority (60%) of neoplasms identified by FNAB. In 16% of these cases, the primary tumor was not identified. The majority (67%) of metastases were from the lung and were predominantly small cell type (52%). Sixty-six ancillary tests were performed on 51 cases (27%). Histologic correlation was available in 78 of 189 (41%) cases, with a diagnostic sensitivity and specificity of 87% to 88% for the detection of neoplasm and 82% to 83% for distinguishing benign from malignant disease. The positive predictive value for the presence of neoplasm was 97% with three cytologic false positives identified. This series is the largest to date on the utility of FNAB for lesions of the mediastinum.
回顾了四个大学医学中心对纵隔进行细针穿刺活检（FNAB）的综合经验。该系列包括189例病例，其中男性100例，女性89例，年龄在6个月至86岁之间。大多数（71%）诊断为肿瘤性病变，其余在非诊断性/不满意结果和非肿瘤性病变之间平均分布。恶性淋巴瘤和胸腺瘤是最常见的原发性恶性肿瘤。转移性肿瘤占FNAB鉴定出的肿瘤的大多数（60%）。在这些病例中，16%未发现原发性肿瘤。大多数（67%）转移瘤来自肺部，且主要为小细胞类型（52%）。对51例（27%）病例进行了66项辅助检查。189例中有78例（41%）可获得组织学相关性，检测肿瘤的诊断敏感性和特异性为87%至88%，区分良性与恶性疾病的诊断敏感性和特异性为82%至83%。确定肿瘤存在的阳性预测值为97%，发现了3例假阳性细胞学结果。该系列是迄今为止关于FNAB对纵隔病变效用的最大规模研究。
