Smith A R, Gilbert C F, Strausbauch P, Silverman J F
Department of Pathology, Pitt County Memorial Hospital, Greenville, North Carolina, USA.
Acta Cytol. 1998 Jul-Aug;42(4):1011-6. doi: 10.1159/000331950.
Mediastinal granular cell tumors (GCT) are extraordinarily rare and have not been previously reported in the cytology literature. Fine needle aspiration (FNA) cytology of GCT resembles the cytologic features of several other lesions that are more common in the mediastinum.
A middle-aged female with a recent onset of nonproductive cough and otherwise unremarkable medical history presented with a mediastinal mass. Imaging studies confirmed the presence of a large mass in the superior, posterior mediastinum closely apposed to the apex of the left lung. FNA revealed scattered large, polygonal to spindle cells with granular cytoplasm and indistinct cell borders. The cytologic differential diagnosis included a benign neural tumor with granular cell features versus GCT. Histologic examination of the surgically resected mass along with supportive immunohistochemical and electron microscopic studies confirmed GCT.
This is the first reported case of FNA cytology of a mediastinal GCT. A reliable diagnosis can be made with aspirated material from these lesions based upon the characteristic cytologic, immunocytochemical and ultrastructural features of the tumors.
纵隔颗粒细胞瘤（GCT）极为罕见，此前细胞学文献中未见报道。GCT的细针穿刺（FNA）细胞学表现类似于纵隔中其他几种更常见病变的细胞学特征。
一名近期出现干咳且既往病史无异常的中年女性，因纵隔肿物就诊。影像学检查证实上纵隔后部有一巨大肿物，紧邻左肺尖。FNA显示散在的大的多边形至梭形细胞，胞质呈颗粒状，细胞边界不清。细胞学鉴别诊断包括具有颗粒细胞特征的良性神经肿瘤与GCT。手术切除肿物的组织学检查以及支持性的免疫组织化学和电子显微镜研究证实为GCT。
这是首例纵隔GCT的FNA细胞学报道病例。根据肿瘤特征性的细胞学、免疫细胞化学和超微结构特征，利用这些病变的抽吸物可做出可靠诊断。
