Abadi M A, Zakowski M F
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Cancer. 1998 Apr 25;84(2):71-6. doi: 10.1002/(sici)1097-0142(19980425)84:2<71::aid-cncr1>3.0.co;2-g.
Sarcomas account for < 6% of malignant effusions and their diagnosis usually is made in the setting of a known primary tumor. However, these tumors often exhibit a variety of features that can differ from those of the original neoplasm and may preclude the correct diagnosis. This article evaluates the cytomorphology of sarcomas in fluids and determines characteristic features for identification and classification.
The study included 24 Papanicolaou-stained fluid samples (15 pleural, 8 peritoneal, and 1 pericardial) from patients with a diagnosis of sarcoma. The following features were evaluated: cellular arrangement, cellularity, nuclear/cytoplasmic ratio, background, quality and quantity of cytoplasm, cell borders, and nuclear details.
All cytology specimens were diagnosed accurately as malignant. The histopathologic diagnoses were eight malignant fibrous histiocytomas, five leiomyosarcomas, three rhabdomyosarcomas, three liposarcomas, two high grade sarcomas, one osteogenic sarcoma, one synovial sarcoma, and one chondrosarcoma. Cytomorphologic features shared by sarcomas in metastatic sites included single cell arrangement (23 of 24; 95.8%), indistinct cell borders (18 of 24; 75.0%), nuclear pleomorphism (18 of 24; 75.0%) multinucleation (13 of 24; 54.2%), and proteinaceous background with lysed blood (17 of 24; 70.8%).
Sarcomas in effusions share morphologic features that allow their correct diagnosis. Further subclassification can be attempted in the proper clinical setting and by comparison with the primary lesion.
肉瘤占恶性积液的比例不到6%，其诊断通常在已知原发性肿瘤的情况下做出。然而，这些肿瘤常常表现出多种与原发肿瘤不同的特征，可能会妨碍正确诊断。本文评估了液体中肉瘤的细胞形态学，并确定了用于识别和分类的特征。
该研究纳入了24例经巴氏染色的液体样本（15例胸腔积液、8例腹腔积液和1例心包积液），这些样本来自诊断为肉瘤的患者。评估了以下特征：细胞排列、细胞密度、核质比、背景、细胞质的质量和数量、细胞边界以及核细节。
所有细胞学标本均被准确诊断为恶性。组织病理学诊断为8例恶性纤维组织细胞瘤、5例平滑肌肉瘤、3例横纹肌肉瘤、3例脂肪肉瘤、2例高级别肉瘤、1例骨肉瘤、1例滑膜肉瘤和1例软骨肉瘤。转移部位肉瘤共有的细胞形态学特征包括单细胞排列（24例中的23例；95.8%）、细胞边界不清（24例中的18例；75.0%）、核多形性（24例中的18例；75.0%）、多核（24例中的13例；54.2%）以及伴有溶血的蛋白质背景（24例中的17例；70.8%）。
积液中的肉瘤具有共同的形态学特征，有助于正确诊断。在适当的临床环境中，并与原发病变进行比较，可以尝试进一步的亚分类。
