Shabb N S
Department of Pathology, American University of Beirut Medical Center, Lebanon.
Acta Cytol. 1997 Mar-Apr;41(2):321-6. doi: 10.1159/000332519.
To elucidate the fine needle aspiration cytology (FNAC) features of phyllodes tumor (PT).
Eight FNAC cases of PT (five benign and three malignant) were reviewed. Features examined were cellularity, epithelial/stromal ratio, phyllodes fragments (PFs), blood vessels crossing PFs, bipolar naked nuclei, stromal pleomorphism, stromal cell size, mitosis, macrophages, sarcomatous component and atypical epithelial component.
Benign PTs were characterized by cellular smears with both stromal and epithelial elements. All cases had many highly cellular stromal fragment PFs. Stromal cells were twice the size of a lymphocyte and lacked pleomorphism. Bipolar naked nuclei were a constant feature. The epithelial component predominated, demonstrating benign ductal groups and cellular areas with discohesion superficially mimicking adenocarcinoma in three cases. FNAC of primary malignant PT (one case) had two patterns, one mimicking benign PT and the other demonstrating a pure sarcomatous component. FNAC of metastatic PTs (two cases) showed pure sarcomatous elements.
The diagnosis of PT is favored over fibroadenoma when many PFs are present. The size and shape of the stromal cell nuclei were not helpful differentiating features in this study. The diagnosis of malignant PT was based on the purely sarcomatous component.
阐明叶状肿瘤（PT）的细针穿刺细胞学（FNAC）特征。
回顾了8例PT的FNAC病例（5例良性和3例恶性）。检查的特征包括细胞密度、上皮/间质比例、叶状碎片（PFs）、穿过PFs的血管、双极裸核、间质多形性、间质细胞大小、有丝分裂、巨噬细胞、肉瘤成分和非典型上皮成分。
良性PT的特征是细胞涂片同时含有间质和上皮成分。所有病例均有许多高度细胞化的间质碎片PFs。间质细胞大小是淋巴细胞的两倍，且无多形性。双极裸核是一个恒定特征。上皮成分占主导，在3例中显示出良性导管群和表面上类似腺癌的细胞解离区域。原发性恶性PT（1例）的FNAC有两种模式，一种类似良性PT，另一种显示为纯肉瘤成分。转移性PT（2例）的FNAC显示为纯肉瘤成分。
当存在许多PFs时，PT的诊断优于纤维腺瘤。在本研究中，间质细胞核的大小和形状无助于鉴别诊断。恶性PT的诊断基于纯肉瘤成分。
