Mulvany N J
Department of Cytology, Royal Women's Hospital, Melbourne, Australia.
Acta Cytol. 1996 Sep-Oct;40(5):911-20. doi: 10.1159/000334002.
To assess the diagnostic value of aspiration cytology in individual cystic lesions of the ovary.
During a 42-month period, 235 cystic ovarian lesions were investigated by fine needle aspiration with cytologic examination (FNA).
Almost 56% (131/235) of the aspirates were devoid of diagnostic cells. The 104 diagnostic aspirates comprised 49 follicular cysts, 4 endometriotic cysts, 45 neoplastic lesions and 6 paraovarian/paratubal cysts. Cyst fluid estradiol (E2) content > 20 nmol/L identified an additional 43 follicular cysts. Histologic examination of the ovarian lesions with acellular cyst fluid containing low E2 revealed 2 corpus luteum hematomas, 1 atretic follicular cyst, 7 endometriotic cysts and 27 serous/mucinous epithelial tumors. The remaining 51 lesions were composed of other entities. Although the specificity of FNA for most nonfollicular cystic ovarian lesions approaches 100%, the sensitivity ranged from 36% for endometriotic cysts to 83% for proliferating/malignant serous tumors.
Prior to FNA of the ovary in an individual patient, consideration should be given to the likely diagnosis, the limitations of the technique and the high false negative rate for nonfollicular cystic lesions.
评估细针穿刺细胞学检查在卵巢单个囊性病变中的诊断价值。
在42个月的时间里，对235例卵巢囊性病变进行了细针穿刺及细胞学检查（FNA）。
几乎56%（131/235）的穿刺液中没有诊断性细胞。104例有诊断意义的穿刺液包括49个滤泡囊肿、4个子宫内膜异位囊肿、45个肿瘤性病变和6个卵巢旁/输卵管旁囊肿。囊液雌二醇（E2）含量>20 nmol/L又识别出43个滤泡囊肿。对囊液无细胞且E2含量低的卵巢病变进行组织学检查，发现2个黄体血肿、1个闭锁滤泡囊肿、7个子宫内膜异位囊肿和27个浆液性/黏液性上皮肿瘤。其余51个病变由其他实体组成。虽然FNA对大多数非滤泡性卵巢囊性病变的特异性接近100%，但其敏感性范围从子宫内膜异位囊肿的36%到增殖性/恶性浆液性肿瘤的83%。
在对个体患者进行卵巢FNA之前，应考虑可能的诊断、该技术的局限性以及非滤泡性囊性病变的高假阴性率。
