Gilcrease M Z, Guzman-Paz M
Department of Laboratory Medicine and Pathology, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.
Diagn Cytopathol. 1998 Sep;19(3):210-5. doi: 10.1002/(sici)1097-0339(199809)19:3<210::aid-dc12>3.0.co;2-h.
Basaloid squamous carcinoma is a distinct variant of squamous carcinoma with a particularly poor prognosis. To our knowledge, there are only two papers in the cytopathology literature which describe this entity. We report the fine-needle aspiration findings of an additional case of metastatic basaloid squamous carcinoma in a cervical lymph node and compare its cytomorphologic features to those observed on touch imprints of the subsequent surgical specimen. Smears of the aspirate showed a mixed lymphoid background with interspersed cohesive clusters of small cells roughly 3 times the size of small mature lymphocytes. Some cells were angulated and others exhibited irregular nuclear contours. The cells were generally hyperchromatic with evenly staining dense chromatin or irregularly distributed coarse chromatin. Focally there was evidence of nuclear molding. On Diff-Quik staining, irregular globules of magenta-stained extracellular dense material were noted within or adherent to the periphery of some clusters or as somewhat linear formations with small epithelial cells clinging to the edges. Abundant mitotic figures and clumps of necrotic tumor were more apparent on touch preps of the subsequent surgical specimen. The differential diagnosis by fine-needle aspiration includes adenoid cystic carcinoma, basal-cell adenocarcinoma, adenosquamous carcinoma, and small-cell carcinoma. If a fine-needle aspirate of a cervical lymph node shows the features described above and the primary tumor is unknown, suggesting the possibility of metastatic basaloid squamous carcinoma may aid clinicians in the search for a primary site, as basaloid squamous carcinoma occurs most frequently at the base of the tongue, hypopharynx, and supraglottic larynx.
基底样鳞状细胞癌是鳞状细胞癌的一种独特变体，预后特别差。据我们所知，细胞病理学文献中仅有两篇论文描述了这一实体。我们报告了1例颈淋巴结转移性基底样鳞状细胞癌的细针穿刺结果，并将其细胞形态学特征与后续手术标本的触摸印片观察结果进行比较。穿刺涂片显示混合淋巴细胞背景，散在分布着紧密聚集的小细胞，其大小约为成熟小淋巴细胞的3倍。一些细胞呈角形，另一些细胞呈现不规则的核轮廓。细胞通常染色过深，染色质均匀致密或分布不规则且粗糙。局部可见核镶嵌现象。在Diff - Quik染色中，在一些细胞团簇内部或周边发现有洋红色染色的细胞外致密物质不规则小球，或呈有点线状的结构，有小上皮细胞附着于边缘。后续手术标本的触摸印片中，丰富的有丝分裂象和坏死肿瘤团块更为明显。细针穿刺的鉴别诊断包括腺样囊性癌、基底细胞腺癌、腺鳞癌和小细胞癌。如果颈淋巴结的细针穿刺显示上述特征且原发肿瘤不明，提示转移性基底样鳞状细胞癌的可能性可能有助于临床医生寻找原发部位，因为基底样鳞状细胞癌最常发生于舌根、下咽和声门上喉。
