Atahan S, Aksu O, Ekinci C
Department of Cytology, Faculty of Medicine, Ankara University, Turkey.
Cytopathology. 1998 Dec;9(6):389-97. doi: 10.1046/j.1365-2303.1998.00131.x.
We reviewed the cytological findings of 38 cases of rhabdomyosarcoma (RMS) with histological confirmation performed during a period of 15 years and proposed a morphological subtyping based on the most prominent cytologic features. Seventeen of these cases were alveolar, 14 cases embryonal, and seven botryoid subtypes. From these cases, a total of 43 samples, of which 37 were fine needle aspiration (FNA) biopsies and six were touch imprints, were evaluated. Detailed cellular features were identified which enabled differentiation into histological subtypes. In the alveolar RMSs, most tumour cells were small and lymphocyte-like, having finely granular chromatin. The finding of cells with more abundant cytoplasm, eccentrically located nuclei and bi/multinucleated tumour cells in a background of mucosubstance helped in the differential diagnosis. Two cell types, including large, tadpole or ribbon-shaped tumour cells and small, round cells with scant cytoplasm, were seen in embryonal RMSs. In botryoid RMSs, a cell type with tightly grouped nuclei within elongated cytoplasm similar to a myotubular structure was observed in addition to the two cell types of embryonal RMSs. We conclude that with experience it will be possible to subtype these tumours by cytologic examination alone.
我们回顾了15年间经组织学证实的38例横纹肌肉瘤（RMS）的细胞学检查结果，并根据最显著的细胞学特征提出了一种形态学亚型分类方法。其中17例为肺泡型，14例为胚胎型，7例为葡萄簇型。从这些病例中，共评估了43份样本，其中37份为细针穿刺（FNA）活检样本，6份为触摸印片样本。确定了详细的细胞特征，有助于区分组织学亚型。在肺泡型RMS中，大多数肿瘤细胞较小，类似淋巴细胞，染色质呈细颗粒状。在黏液物质背景下发现具有更丰富细胞质、偏心核的细胞以及双核/多核肿瘤细胞有助于鉴别诊断。在胚胎型RMS中可见两种细胞类型，包括大的、蝌蚪状或带状肿瘤细胞以及细胞质稀少的小圆形细胞。在葡萄簇型RMS中，除了胚胎型RMS的两种细胞类型外，还观察到一种细胞类型，其细胞核紧密聚集在细长的细胞质内，类似于肌管结构。我们得出结论，凭借经验，仅通过细胞学检查就有可能对这些肿瘤进行亚型分类。
