子宫颈绒毛管状腺癌在液基细胞学中的特点  

Cytomorphologic features of liquid-based cytology from villoglandular adenocarcinoma of the uterine cervix

作　　者：刘栋[1] 武岳[1] 周辉蓉[1] 李晶[1] 吴赛西 赖李忠 郑宏刚[1] 梁小曼[2] 

机构地区：[1]广州金域医学检验中心病理科,广州510330 [2]中山大学附属肿瘤医院病理科,广州510060

出　　处：《临床与实验病理学杂志》2016年第11期1235-1238,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的 探讨绒毛管状腺癌（villoglandular adenocarcinoma,VGA）在液基涂片中的细胞学形态、诊断要点、鉴别诊断及其价值。方法 收集VGA的液基细胞学7例,并复习相关文献、分析总结VGA液基细胞学的诊断要点。结果 7例液基细胞学均有以下特点：肿瘤细胞量丰富,呈团簇状、条带状或片状排列,可见乳头状结构,乳头边界光滑,外周被覆极向较好、细胞胞界清楚的柱状上皮,可见栅栏状及羽翼状结构。细胞核相对一致,排列拥挤,明显重叠。细胞核轻度增大,圆形或被拉长,染色较深但染色质细腻,核仁不明显,部分病例可见小核仁,核分裂象及凋亡可见。背景可有出血、炎症,无肿瘤素质。结论 与普通型子宫颈腺癌相比,VGA的细胞形态相对温和,细胞学病例易漏诊或诊断不足。大量呈轻~中度不典型增生的腺上皮、明确的乳头状结构、拥挤的细胞排列,可作为VGA液基细胞学的诊断线索。Purpose To discuss the cytomorphologic essencials of diagnosis and differential diagnosis of villoglandular adenocarcinoma （VGA） in liquid-based cytology. Method Liquid-based cytology from 7 cases of VGA were collected and the relevant literatures were reviewed. The main points of liquid-based cytology of VGA werw analysed and summarized. Result The common cytologic features of VGA were abundant tumor cells in a fairly clean background which showed clusters, strips, sheets or/and papillary fragments with smooth border and well-oriented edge. The nuclei were uniform but crowded with distinctive overlapping, increased in size and round or elongated in shape, evenly distributed hyperchromatic granular chromatin with mostly inconspicuous nuleoli, mitotic figures were occa- sionally seen. No tumor diathesis was seen. Conclusion Cervical VGA could be under-diagnosed due to the relatively mild morpho- logic alterations. However, presence of the papillary structures, crowded and overlapping nuclei and abundant glandular epithelial cells with mild to moderate atypia could be the helpful hints.

关 键 词：子宫颈肿瘤 绒毛管状腺癌 液基细胞学 

分 类 号：R361.3[医药卫生—病理学]