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Intraductal papillary mucinous neoplasms of the pancreas: Cytologic-histologic correlation study and evaluation of the cytologic accuracy in identifying high-grade dysplasia/invasive adenocarcinoma. 胰腺导管内乳头状黏液瘤:细胞学与组织学相关性研究及评估细胞学鉴定高级别发育不良/浸润性腺癌的准确性。
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2024-01-31 eCollection Date: 2024-01-01 DOI: 10.25259/Cytojournal_71_2023
Serenella Serinelli, Kamal K Khurana

Objective: Intraductal papillary mucinous neoplasms (IPMNs) may be associated with invasive adenocarcinoma, low-grade dysplasia (LGD), or high-grade dysplasia (HGD). We aimed to review the cytologic-histologic correlation of cases with a histologic diagnosis of IPMN.

Material and methods: A database search (January 2010-January 2021) was performed for resected IPMNs with preceding endoscopic ultrasound-guided fine-needle aspiration (FNA). Cytology slides were reviewed for the presence of benign, atypical, or malignant cells, and necrosis. Histologically, IPMNs were classified as benign (LGD) or malignant (HGD or adenocarcinoma).

Results: There were 41 patients with IPMN; 24 malignant and 17 benign. Sixteen of the 24 malignant IPMNs were accurately classified as malignant on cytology. There were eight false negatives and one false positive. Cytology yielded a sensitivity of 67% and a specificity of 94%. Among the 16 true positives with FNA diagnosis of adenocarcinoma, seven were IPMNs with HGD, and nine had invasive adenocarcinomas on histology. Cellular morphology and absence or presence of necrosis did not help distinguish HGD from adenocarcinoma on cytology (P > 0.5). Sampling errors and interpretative errors resulted in false-negative cases. Cytology yielded diagnoses related to IPMN in 73% of cases (30/41) and lack of identification of mucinous cells/mucinous background resulted in interpretative errors (9).

Conclusion: This study shows that there is a good correlation between cytopathology and surgical pathology diagnoses of IPMNs and that cytology is mostly able to recognize IPMN with HGD/adenocarcinoma. However, heterogeneity in areas of IPMN with HGD/adenocarcinoma may result in sampling errors yielding false-negative cases. Mucinous cells/background should raise the suspicion of IPMN on cytology, even when no neoplastic epithelium is present for the evaluation of dysplasia.

目的:导管内乳头状粘液瘤(IPMN)可能与浸润性腺癌、低度发育不良(LGD)或高度发育不良(HGD)有关。我们旨在回顾组织学诊断为 IPMN 的病例的细胞学和组织学相关性:在数据库中搜索(2010 年 1 月至 2021 年 1 月)切除的 IPMN,并进行内镜超声引导下细针穿刺(FNA)。对细胞学切片进行审查,以确定是否存在良性、非典型或恶性细胞以及坏死。从组织学角度将 IPMNs 分为良性(LGD)或恶性(HGD 或腺癌):41例IPMN患者中,24例为恶性,17例为良性。在 24 个恶性 IPMN 中,有 16 个在细胞学检查中被准确分类为恶性。其中有 8 例假阴性和 1 例假阳性。细胞学检查的敏感性为 67%,特异性为 94%。在 16 例经 FNA 诊断为腺癌的真阳性病例中,7 例为伴有 HGD 的 IPMN,9 例经组织学检查为浸润性腺癌。细胞形态和有无坏死无助于区分细胞学上的 HGD 和腺癌(P > 0.5)。取样错误和解释错误会导致假阴性病例。73%的病例(30/41)的细胞学诊断结果与 IPMN 有关,而无法识别粘液细胞/粘液背景导致了解释错误(9):本研究表明,细胞病理学和手术病理学对 IPMN 的诊断有很好的相关性,细胞学大多能识别伴有 HGD/腺癌的 IPMN。不过,伴有 HGD/腺癌的 IPMN 区域的异质性可能会导致取样错误,从而产生假阴性病例。粘液细胞/背景应在细胞学检查中引起对 IPMN 的怀疑,即使在评估发育不良时没有出现肿瘤上皮。
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引用次数: 0
Atypical epithelioid cells in pleural effusion as foreign second population: A diagnostic cytopathology dilemma. 胸腔积液中的非典型上皮样细胞作为外来第二人群:细胞病理学诊断难题。
IF 2.5 4区 医学 Q2 PATHOLOGY Pub Date : 2024-01-31 eCollection Date: 2024-01-01 DOI: 10.25259/Cytojournal_23_2023
Shengnan Zhao, Likun Hou, Wei Wu, Chunyan Wu
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引用次数: 0
Contemporary art of cell-block preparation: Overview. 细胞块制备的当代艺术:概述。
IF 2.5 4区 医学 Q2 PATHOLOGY Pub Date : 2024-01-31 eCollection Date: 2024-01-01 DOI: 10.25259/Cytojournal_56_2023
Samah Saharti

Cell blocks (CBs) are paraffin-embedded versions of cytology specimens. These versions are contrasted with tissues made from surgical pathology specimens of formalin-fixed paraffin-embedded (FFPE) tissue. CBs enable various elective ancillary studies of a range of specimens. These studies include the potential to perform molecular tests with the enhanced cytopathological interpretation. CBs are increasingly reported in cytology specimens. The enhanced role of CBs incorporates additives with new markers for immunohistochemistry (IHC), including the multicolored approach to IHC, and the subtractive coordinate immunoreactivity pattern. Even when archived material is retrospectively retrieved, CBs are a major tissue source for many supplementary studies. The CBs have been qualitatively and quantitatively improved. CBs are significant since they have increased molecular markers standardized on FFPE tissue. High-quality CBs can serve as useful additions to cytological smear preparations and touch imprint cytology. Most cytological specimens, such as fine-needle aspirations, cavitary effusion, washings, brushings, and gynecological and non-gynecological liquid specimens, may be used to produce CBs. This review deals with the CB-making process and discusses various historical limitations with an emphasis on recent advances.

细胞块(CB)是细胞学标本的石蜡包埋版本。这些细胞块与由福尔马林固定石蜡包埋(FFPE)的手术病理标本制成的组织形成对比。CBs 可以对一系列标本进行各种选择性辅助研究。这些研究包括利用增强的细胞病理学解释进行分子检测。细胞病理学标本中的 CBs 报告越来越多。CBs 的增强作用包括添加免疫组化(IHC)的新标记物,包括 IHC 的多色方法和减色坐标免疫反应模式。即使是回顾性检索存档材料,CB 也是许多补充研究的主要组织来源。CBs 在质量和数量上都得到了改进。CBs 具有重要意义,因为它们增加了 FFPE 组织标准化的分子标记。高质量的 CB 可作为细胞学涂片制备和触摸印迹细胞学的有益补充。大多数细胞学标本,如细针抽吸、腔积液、冲洗液、刷涂液以及妇科和非妇科液体标本,都可用于制作 CBs。这篇综述介绍了 CB 的制作过程,并讨论了各种历史局限性,重点介绍了最新进展。
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引用次数: 0
Pancreatic tuberculosis – A common disease at a rare site diagnosed on cytology 胰腺结核--细胞学诊断中罕见部位的常见疾病
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2024-01-04 DOI: 10.25259/cytojournal_33_2023
Paruvathavarthini Thambiraj, Vijayalakshmi Gudivada, D. Gochhait, N. Siddaraju, Biju Pottakat
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引用次数: 0
HPV-negative and high-grade finding in Pap cytology 巴氏细胞学中的 HPV 阴性和高级别发现
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2024-01-04 DOI: 10.25259/cytojournal_57_2023
Deepti Jain, Leana Elbashir, V. Shidham
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引用次数: 0
Transbronchial brushing cytology and paired biopsy in endobronchial tuberculosis: A report of 72 cases focusing on the morphological features 支气管内膜结核的经支气管刷状细胞学检查和成对活检:72 例病例的报告,侧重于形态学特征
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2023-12-05 DOI: 10.25259/cytojournal_35_2023
Zhihua Lan, Jing Zhang, Xin Ma, Rongfang He, Qiang Zhao, Fang Yang
The objectives of this study were to review the transbronchial brushing cytology and histological specimens of endobronchial tuberculosis (EBTB) and to explore the morphological features, diagnostic pitfalls, and dilemmas.Transbronchial brushing cytology and concurrent biopsy specimens obtained between July 2017 and June 2020 were reviewed. EBTB was confirmed based on the clinical response to the anti-TB treatment in addition to the positive findings of at least one of the following methods: Acid-fast bacilli stain (AFB), auramine-rhodamine stain (A-R), detection of TB bacterial DNA (TB-DNA) by polymerase chain reaction, T-cell spot test (T-spot), and typical pathologic changes of TB on cytology or bronchoscopy biopsy. A total of 72 confirmed cases were studied.Of the 72 patients, 42/72 (58.3%) and 30/72 (41.7%) were female and male patients, respectively. Bronchoscopic findings revealed five subtypes of EBTB, including inflammation infiltration, ulceration necrosis, granulation hyperplasia, cicatrices stricture, and tracheobronchial malacia. AFB, A-R, TB-DNA, and T-spot were positive in 39, 26, 33, and 46 cases, respectively. The detection rate of necrosis in the cytological specimens (90.3%) was significantly higher than that in the biopsy specimens (77.8%; P < 0.01). The percentage of Langhans giant cells detected by cytology (13.9%) was significantly lower than that detected by the pathological examinations of the tissues (38.9%) (P < 0.01). The detection rates of metaplastic squamous cells and epithelioid cells showed no significant difference with respect to the cytology and biopsy findings. In addition to the two patients who had concurrent carcinomas, atypical cells were reported in nine patients through cytopathological diagnosis, among them two were suspected to have carcinomas, two were with the impression that spindle cell neoplasms could not be excluded, and the other five were considered as reactive atypia. Moreover, one biopsy could not rule out the well-differentiated squamous cell carcinoma.Some morphological variations may cause challenges in cytological evaluation. Moreover, diagnostic dilemmas can occur even in the assessments of tissue pathology.
本研究的目的是回顾支气管内结核(EBTB)的经支气管刷诊细胞学和组织学标本,并探讨其形态学特征、诊断陷阱和困境。回顾了2017年7月至2020年6月期间获得的经支气管刷刷细胞学和同期活检标本。根据抗结核治疗的临床反应以及以下方法中至少一种的阳性结果确认EBTB:抗酸杆菌染色(AFB), auramine-rhodamine染色(A-R),聚合酶链反应检测结核细菌DNA (TB-DNA), t细胞斑点试验(T-spot),细胞学或支气管镜活检的典型结核病理改变。共对72例确诊病例进行了研究。72例患者中,女性42/72例(58.3%),男性30/72例(41.7%)。支气管镜检查结果显示EBTB有5种亚型,包括炎症浸润、溃疡坏死、肉芽增生、瘢痕狭窄和气管支气管软化。AFB阳性39例,A-R阳性26例,TB-DNA阳性33例,T-spot阳性46例。细胞学标本坏死检出率(90.3%)明显高于活检标本(77.8%);P < 0.01)。细胞学检查的朗汉斯巨细胞检出率(13.9%)显著低于组织病理学检查的朗汉斯巨细胞检出率(38.9%)(P < 0.01)。化生鳞状细胞和上皮样细胞的检出率在细胞学和活检结果方面无显著差异。除2例合并癌外,9例经细胞病理学诊断为非典型细胞,其中2例怀疑为癌,2例印象不能排除梭形细胞肿瘤,另外5例考虑为反应性异型。此外,一次活检不能排除高分化鳞状细胞癌。一些形态学上的变异可能会给细胞学评价带来挑战。此外,甚至在组织病理学评估中也可能出现诊断困境。
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引用次数: 0
Cytomorphology of papillary renal neoplasm with reverse polarity. 具有反向极性的乳头状肾肿瘤的细胞形态学。
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2023-11-23 eCollection Date: 2023-01-01 DOI: 10.25259/Cytojournal_9_2023
Swati Satturwar, Anil V Parwani
Papillary renal neoplasm with reverse nuclear polarity (PRNRP) is an emerging oncocytic renal tumor. Cytomorphologic features of this tumor have not been described in the literature before. The objective of this study was to review the cytomorphology of a case PRNRP and compare with cytomorphologic features of papillary renal cell carcinomas (pRCCs) reported in the literature. 1 case of core needle biopsy (CNB) with touch preparation (TP) of a renal mass diagnosed as PRNRP was reviewed retrospectively. Clinical presentation, cytomorphologic features, ancillary tests and histopathology results were analyzed. The touch preparation was cellular and showed tight 3-D clusters of cuboidal epithelial cells with variable presence of fibrovascular cores (FC), granular eosinophilic cytoplasm, round apically located grade 1 nuclei compared to cases of pRCC that consistently showed presence of FCs lined by cuboidal to columnar epithelial cells with variable degree of cytologic atypia. Features characteristic of pRCC like foamy macrophages, hemosiderin laden macrophages, nuclear grooves or psammoma bodies were not present. No necrosis or mitosis were identified. By immunohistochemistry (IHC) the tumor cells were positive for cytokeratin 7, GATA-3 and AMACR (focal) and negative for CA-IX, CD117 and vimentin. Cytomorphologic features of PRNRP are unique and characterized by tight 3-D clusters (with or without FCs) of cuboidal cells with small round apically located nuclei and finely granular oncocytic cytoplasm. Specific diagnosis of PRNRP on cytology or CNB is feasible along with use of ancillary tests IHC and /or molecular tests.
具有反向核极性的乳头状肾肿瘤(PRNRP)是一种新出现的肿瘤性肾肿瘤。该肿瘤的细胞形态学特征尚未见于文献。本研究旨在回顾一例 PRNRP 的细胞形态学,并将其与文献报道的乳头状肾细胞癌(pRCC)的细胞形态学特征进行比较。本研究回顾性分析了1例被诊断为PRNRP的肾肿块核心针活检(CNB)和触摸制备(TP)病例。对临床表现、细胞形态学特征、辅助检查和组织病理学结果进行了分析。与pRCC病例相比,该病例的细胞形态学特征为细胞学特征,表现为立方体上皮细胞的紧密三维团块,伴有不同程度的纤维血管核(FC)、颗粒状嗜酸性细胞质、圆形顶部1级核,而pRCC病例则始终表现为立方体至柱状上皮细胞内衬的FC,伴有不同程度的细胞学不典型性。pRCC 的特征如泡沫状巨噬细胞、含血色素的巨噬细胞、核沟或脓肿体均不存在。未发现坏死或有丝分裂。免疫组化(IHC)显示,肿瘤细胞的细胞角蛋白7、GATA-3和AMACR(灶性)阳性,CA-IX、CD117和波形蛋白阴性。PRNRP 的细胞形态学特征非常独特,其特点是立方体细胞紧密的三维团块(有或无 FC),核小而圆,位于顶部,具有细颗粒状的肿瘤细胞胞质。通过细胞学或 CNB 可以明确诊断 PRNRP,同时还可以使用辅助检测 IHC 和/或分子检测。
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引用次数: 0
Prevalence of abnormal pap smears in the western region of Saudi Arabia from 2010 to 2022. 2010 年至 2022 年沙特阿拉伯西部地区子宫颈抹片检查异常的流行率。
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2023-11-23 eCollection Date: 2023-01-01 DOI: 10.25259/Cytojournal_17_2023
Abdulbasit A Andijany, Daliah A Abdulhafeez, Rehab B Fadag, Abdullah M Al Harbi, Rasha A Alsahafi, Elham S Bin Abbas, Walaa A Felemban

Objectives: The objectives of the study were to assess the prevalence of abnormal Pap smears and their quality metrics in a tertiary health-care facility in the western region of Saudi Arabia and to share our data with other researchers in Saudi Arabia to potentially establish benchmark data based on a Saudi population.

Material and methods: A retrospective study was carried out by the Department of Pathology at King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia, on Pap smear statistics for 14,376 Pap smears of both conventional and liquid-based cytology (LBC) between 2010 and 2022.

Results: The prevalence of abnormal Pap smears of both conventional and LBC was 3.05% (438 Pap smears). The percentages of adenocarcinoma and squamous cell carcinoma were 0.08% and 0.02%, respectively, and the ratio of atypical squamous cells (ASCs) to squamous intraepithelial lesions (SILs) (ASC/SIL) was 2.61.

Conclusion: The prevalence of abnormal Pap smears and the ASC/SIL ratio were consistent with the international benchmark data provided by the College of American Pathologists for each preparation type and within the range of the data provided by published studies, highlighting the need for greater focus on glandular abnormalities.

研究目的本研究的目的是评估沙特阿拉伯西部地区一家三级医疗机构中巴氏涂片异常的发生率及其质量指标,并与沙特阿拉伯的其他研究人员分享我们的数据,以建立基于沙特人口的基准数据:沙特阿拉伯吉达法赫德国王武装部队医院病理科对2010年至2022年期间14376例传统和液基细胞学(LBC)巴氏涂片统计数据进行了回顾性研究:结果:常规和液基细胞学巴氏涂片的异常发生率均为 3.05%(438 例)。腺癌和鳞癌的比例分别为 0.08% 和 0.02%,非典型鳞状细胞(ASC)与鳞状上皮内病变(SIL)的比例(ASC/SIL)为 2.61:巴氏涂片异常的发生率和 ASC/SIL 比率与美国病理学家学会为每种制备类型提供的国际基准数据一致,也在已发表研究提供的数据范围内,这突出表明需要更加关注腺体异常。
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引用次数: 0
Cytomorphology of skin adnexal tumors and its correlation with histopathology in a tertiary care center. 三级护理中心皮肤附件肿瘤的细胞形态学及其与组织病理学的相关性。
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2023-10-09 eCollection Date: 2023-01-01 DOI: 10.25259/Cytojournal_19_2023
Juhi Shahab, Smriti Sharan, Mukul Singh, Sana Ahuja, Charanjeet Ahluwalia, Meetu Agrawal, Sunil Ranga

Objectives: Even though fine-needle aspiration cytology (FNAC) can be successfully used for describing the cytomorphology of skin adnexal tumors and can help in identification of them as benign or malignant, histopathology remains the gold standard in confirmation of diagnosis. Skin adnexal tumors are a large and diverse group and are relatively less commonly encountered in routine practice; hence, knowledge of cytological features of these lesions is crucial for their appropriate management. The present study aims to evaluate the cytomorphological features of skin adnexal tumors on FNAC smears and their correlation with the histopathology.

Material and methods: This is a retrospective study of FNAC of 60 cases of subcutaneous and dermal swellings over a period of 4 years from August 2018 to August 2022 in a tertiary care center.

Results: In the 60 cases of skin adnexal tumors evaluated, most cases were within the 2nd to 4th decade with male predominance. The FNA smears were helpful in picking up the nature of skin adnexal tumors, as in our case series, malignant lesions were 8.3% and benign were 91.7%. Majority adnexal lesions were of follicular or sebaceous differentiation. Histological diagnosis was available in 38 cases. Cytological diagnosis in 34 cases was concordant with histopathology. There was discrepancy observed in two cases which were reported as benign skin adnexal tumor but later turned out to be sebaceous carcinoma on histopathology.

Conclusion: Even though histopathology being the gold standard for confirmation of diagnosis, in the current era of minimally invasive procedures, FNAC stands out as a valuable modality and can be a promising alternative to diagnose skin adnexal tumors and understand their cytomorphology as the data are limited about it.

目的:尽管细针抽吸细胞学(FNAC)可以成功地用于描述皮肤附件肿瘤的细胞形态,并有助于识别其为良性或恶性,但组织病理学仍然是确认诊断的金标准。皮肤附件肿瘤是一个庞大而多样的群体,在常规实践中相对不常见;因此,了解这些病变的细胞学特征对于正确处理至关重要。本研究旨在评估FNAC涂片上皮肤附件肿瘤的细胞形态学特征及其与组织病理学的相关性。材料和方法:这是一项在2018年8月至2022年8月的4年时间里,在一家三级护理中心对60例皮下和真皮肿胀的FNAC进行的回顾性研究。结果:在评估的60例皮肤附件肿瘤中,大多数病例发生在2-4十年内,以男性为主。FNA涂片有助于了解皮肤附件肿瘤的性质,在我们的病例系列中,恶性病变占8.3%,良性病变占91.7%。大多数附件病变为毛囊或皮脂腺分化。组织学诊断38例。34例的细胞学诊断与组织病理学一致。在两例报告为良性皮肤附件肿瘤但后来在组织病理学上被证明为皮脂腺癌的病例中观察到差异。结论:尽管组织病理学是确诊的金标准,但在当前微创手术时代,FNAC是一种有价值的方法,可以作为诊断皮肤附件肿瘤和了解其细胞形态的一种有前途的替代方法,因为相关数据有限。
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引用次数: 0
Cytomorphology of mesenchymal lesions in a tertiary care centre and its correlation with histopathology. 三级护理中心间充质病变的细胞形态学及其与组织病理学的相关性。
IF 1.9 4区 医学 Q3 Medicine Pub Date : 2023-10-09 eCollection Date: 2023-01-01 DOI: 10.25259/Cytojournal_2_2023
Juhi Shahab, Rashi Maheshwari, Mukul Singh, Rohit Sharma, Charanjeet Ahluwalia, Sufian Zaheer, Sana Ahuja

Objectives: Fine needle aspiration cytology (FNAC) is a minimally invasive method for sampling a heterogenous lesion. It is one of the first-line investigations in the evaluation of soft tissue tumours. However, the heterogeneity of mesenchymal lesions pose a challenge to the cytological diagnosis. The present study aims at evaluation of the cytomorphological findings of mesenchymal lesions on FNAC along with their histopathological correlation.

Material and methods: This was a retrospective study conducted over a period of 1 year from January 2021 to January 2022. All the patients of cytologically diagnosed mesenchymal lesions on their FNA aspirates were included in the study. Cytomorphology of the May Grunwald Giemsa and Papanicolaou stained slides were examined and correlated with clinical and histopathological details wherever available.

Results: Out of the 90 patients, 69 (76.7%) were males and 21 (23.3%) were females. Maximum number of cases were in 4-5th decade of life. The lower limb was found to be the most common site (57.8%) for the mesenchymal lesions. Majority of the cases on FNA in our study were found to be benign - 79 (87.8%), while only 11 cases were malignant (12.2%). On cytological examination, spindle cell lesions were most common followed by adipocytic lesions. Based on the cyto-histological correlation, sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of FNAC in diagnosis of mesenchymal lesion was 78.6%, 100%, 92.5%, 100% and 94.1% respectively.

Conclusion: FNAC is a simple and minimally invasive tool that plays an important role in triaging patients with good specificity and sensitivity.

目的:细针抽吸细胞学(FNAC)是一种对异质性病变进行采样的微创方法。它是评估软组织肿瘤的一线研究之一。然而,间充质病变的异质性对细胞学诊断提出了挑战。本研究旨在评估FNAC上间充质病变的细胞形态学表现及其组织病理学相关性。材料和方法:这是一项为期1年的回顾性研究,从2021年1月到2022年1月。所有在FNA抽吸物上细胞学诊断为间充质病变的患者都包括在研究中。检查May-Grunwald-Giemsa和Papanicolaou染色载玻片的细胞形态,并将其与临床和组织病理学细节联系起来。结果:90例患者中,男性69例(76.7%),女性21例(23.3%)。病例最多发生在生命的第4-5个十年。下肢是间充质病变最常见的部位(57.8%)。在我们的研究中,大多数FNA病例是良性的-79例(87.8%),而只有11例是恶性的(12.2%)。在细胞学检查中,梭形细胞病变最常见,其次是脂肪细胞病变。根据细胞组织学相关性,FNAC诊断间充质病变的敏感性、特异性、阴性预测值、阳性预测值和诊断准确率分别为78.6%、100%、92.5%、100%和94.1%。结论:FNAC是一种简单、微创的工具,具有良好的特异性和敏感性,在分诊中起着重要作用。
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引用次数: 0
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