Cina S J, Smialek J E
Office of the Chief Medical Examiner, State of Maryland, Baltimore 21201, USA.
Am J Forensic Med Pathol. 1997 Dec;18(4):331-4. doi: 10.1097/00000433-199712000-00003.
Cytologic evaluation of nongynecologic tissues is a widely accepted diagnostic modality commonly used in the clinical evaluation of living patients. Fine needle aspiration (FNA) of superficial masses and touch preparations of surgical specimens often yield diagnostic results. The adjunctive role of these two techniques during postmortem examination has not been adequately addressed. A prospective study was carried out on a series of 13 patients undergoing postmortem examination. FNA was performed in a standard manner to obtain tissue fragments from superficial masses in three cases. Visceral lesions grossly suspicious for cancer were scraped and smeared onto glass slides to create a "touch prep" in 10 cases. Cytologic evaluation of alcohol-fixed, hematoxylin and eosin (H&E)-stained slides was performed in each case. Cytologic diagnoses were subsequently correlated with histologic sections. In the majority of cases, cytologic material was diagnostic. Touch prep slides, in combination with gross findings, were diagnostic of primary and metastatic carcinoma in visceral lesions. FNA of superficial masses accurately assessed local recurrences of carcinoma and nodal metastases. Both methods yielded diagnoses within minutes, in contrast to the time required to process routine histologic sections. Cytologic evaluation of tissues obtained at autopsy provides accurate, inexpensive, and rapid diagnostic information. The touch prep is an inexpensive adjunct to histologic sections in documenting the presence of carcinoma or the extent of metastatic disease found at autopsy, and its further application can strengthen the standard applied in clinicopathologic diagnosis.
非妇科组织的细胞学评估是一种广泛接受的诊断方法，常用于活体患者的临床评估。浅表肿块的细针穿刺抽吸（FNA）和手术标本的触摸涂片通常能得出诊断结果。这两种技术在尸检中的辅助作用尚未得到充分探讨。对13例接受尸检的患者进行了一项前瞻性研究。3例患者以标准方式进行FNA，以获取浅表肿块的组织碎片。10例患者对肉眼高度怀疑为癌症的内脏病变进行刮擦并涂抹在载玻片上制成“触摸涂片”。对每例经酒精固定、苏木精和伊红（H&E）染色的玻片进行细胞学评估。随后将细胞学诊断结果与组织学切片进行对比。在大多数病例中，细胞学材料具有诊断价值。触摸涂片玻片结合大体检查结果，可诊断内脏病变中的原发性和转移性癌。浅表肿块的FNA能准确评估癌的局部复发和淋巴结转移。与处理常规组织学切片所需时间相比，这两种方法在数分钟内即可得出诊断结果。尸检时获取组织的细胞学评估可提供准确、廉价且快速的诊断信息。触摸涂片是组织学切片的一种廉价辅助手段，可用于记录尸检时发现的癌的存在或转移疾病的范围，其进一步应用可强化临床病理诊断的标准。
