Ali S Z, Kronz J D, Plowden K M, Erozan Y S
John K. Frost Cytopathology Laboratory, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland 21287-6940, USA.
Diagn Cytopathol. 1998 Apr;18(4):280-3. doi: 10.1002/(sici)1097-0339(199804)18:4<280::aid-dc6>3.0.co;2-g.
Pulmonary metastasis of sarcomas is not uncommon. Rarely, endobronchial involvement may result in exfoliation of diagnostic cells in sputum. This case report is of a 71-yr-old man with a history of lower leg leiomyosarcoma who developed multiple lung metastases. Sputum examination revealed malignant cells with pleomorphic, elongated, and cigar-shaped nuclei and occasional bipolar cytoplasmic processes. Immunoperoxidase studies on the smears using desmin and smooth muscle actin were strongly positive, consistent with leiomyosarcoma. Confirmation of metastatic lung disease by sputum cytology not only has prognostic importance but also obviates the need for further investigations.
肉瘤的肺转移并不罕见。极少情况下，支气管内受累可能导致痰液中诊断性细胞脱落。本病例报告的是一名71岁男性，有小腿平滑肌肉瘤病史，发生了多发性肺转移。痰液检查发现恶性细胞，其细胞核多形、细长且呈雪茄状，偶尔可见双极细胞质突起。使用结蛋白和平滑肌肌动蛋白对涂片进行免疫过氧化物酶研究呈强阳性，符合平滑肌肉瘤表现。通过痰液细胞学确诊肺转移疾病不仅具有预后重要性，还避免了进一步检查的必要。
