骨肿瘤的针吸细胞学诊断

目的：探讨骨肿瘤针吸细胞学的诊断标准。方法：分析４６例骨肉瘤针吸细胞学涂片，并与２４例骨巨细胞瘤和１２例骨转移性癌进行对照，找出骨肉瘤的细胞学特征，并与组织学对照分析。结果：观察到骨肿瘤中有关１０种细胞学改变：骨肉瘤涂片中，多形性大细胞（９１．３％），核仁明显（６９．５％），单核瘤巨细胞（７６％），多核瘤巨细胞（６５．２％），核分裂象（３６．９％），出血、坏死（９３．４％）。骨巨细胞瘤以多核巨细胞

Needle aspiration cytologic diagnosis for osseous tumor

Purpose To determine the role of needle aspiration cytology in the diagnosis of osteosarcoma.Methods Forty six cases of osteosarcoma, 24 giant cell tumor and 12 metastatic tumors of the bone were evaluated by needle aspiration. The characteristics of cytology were compared with the histopathology of the subsequent operation specimens. Results Ten categories of cytologic features found in the smear of osseous tumors were pleomorphic giant nuclear cell (91 3%), obvious nucleoli(69 5%),mononuclear gaint cell(76%), multinuclear gaint cell(65 2%),karyokinesis(36 9%), hemorrhage and necrosis(93 4%). The dominant features of bone giant cell tumor were multinuclear tumor giant cell(100%) and mononuclear tumor cell(87 5%). Pleomorphic giant nucleus(100%), obvious nucleoli(75%) and karyokinesis were the main elements in the smear of bone metastatic carcinoma. Hemorrhage and necrosis were found among three bone lesions. The diagnostic accuracy rates were 93 4% in osteosarcoma, 87 5% in bone giant cell tumor, 91 6% in bone metastatic carcinoma. Conclusion Needle aspiration is a simple, accurate technique. Combining with clinical history and X ray finding it can improve the diagnostic accuracy of osseous tumors.