Cytomorphological Features of Fine Needle Aspiration in 11 Conventional and 2 Dedifferentiated Chordomas: Correlation With Histopathology

IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Eva Manuela Pena-Burgos, Pilar López-Ferrer, Jose Juan Pozo-Kreilinger, Ana Margarita Rodríguez-García
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引用次数: 0

Abstract

Background

Chordoma is a rare malignant tumor of notochordal origin with well-established histologic features and typically distinctive cytomorphology. Fine-needle aspiration (FNA) can offer a valuable diagnostic tool in deep-seated or challenging lesions. However, distinguishing conventional and dedifferentiated chordomas based on cytological features remains difficult and poorly documented.

Methods

Thirteen FNA samples from 10 patients with histologically confirmed chordoma (11 conventional and 2 dedifferentiated), retrieved from the pathology files of a tertiary referral hospital between 1966 and 2022, were retrospectively reviewed. Cytomorphological features were analyzed and correlated with histological subtype and immunohistochemical profile.

Results

All cases showed physaliphorous cells embedded in a myxoid matrix, with varying proportions of single cells and clusters. Prominent nucleoli, binucleation, and nuclear pseudoinclusions were frequently observed. Cytologic atypia and pleomorphism were notable in the dedifferentiated cases but also present, to a lesser extent, in some conventional chordomas. No definitive cytological features of sarcomatous transformation were identified in the smears of dedifferentiated chordoma. Immunohistochemistry supported the diagnosis in selected cases, with positivity for brachyury, cytokeratins, EMA, and negativity for S100 in the physaliphorous cells. Brachyury loss in dedifferentiated areas complicates diagnosis, underscoring the need for conventional component identification.

Conclusion

Chordoma shows distinctive yet variable cytomorphological features that can allow for a reliable diagnosis in FNA samples. Clinical and radiological correlation is essential to guide sampling, especially in the dedifferentiated cases, and avoid misinterpretation. Some cytological features typically associated with dedifferentiation may be present in conventional chordomas, underscoring the importance of cautious interpretation and histological confirmation.

11例常规脊索瘤和2例去分化脊索瘤细针穿刺的细胞形态学特征:与组织病理学的相关性
背景脊索瘤是一种罕见的脊索起源的恶性肿瘤,具有明确的组织学特征和典型的独特的细胞形态。细针穿刺(FNA)可以为深部或挑战性病变提供有价值的诊断工具。然而,根据细胞学特征区分常规脊索瘤和去分化脊索瘤仍然很困难,而且文献很少。方法回顾性分析某三级转诊医院1966 ~ 2022年病理资料中10例经组织学证实的脊索瘤患者(11例为常规脊索瘤,2例为去分化脊索瘤)的13例FNA样本。分析细胞形态学特征,并与组织学亚型和免疫组织化学谱相关联。结果所有病例均可见黏液样基质中包埋的物理脂质细胞,单细胞和细胞簇的比例不同。核仁、双核、假包涵体明显。细胞非典型性和多形性在去分化病例中是显著的,但在一些常规脊索瘤中也存在,但程度较轻。去分化脊索瘤涂片未发现肉瘤转化的明确细胞学特征。免疫组织化学在部分病例中支持诊断,在嗜物理脂肪细胞中,brachyury、细胞角蛋白、EMA呈阳性,而S100呈阴性。去分化区域的短肌腱缺失使诊断复杂化,强调了常规成分识别的必要性。结论脊索瘤表现出独特而多变的细胞形态学特征,可以在FNA样本中进行可靠的诊断。临床和放射学相关性对于指导采样至关重要,特别是在去分化病例中,并避免误解。一些典型的与去分化相关的细胞学特征可能出现在常规脊索瘤中,强调谨慎解释和组织学证实的重要性。
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来源期刊
Diagnostic Cytopathology
Diagnostic Cytopathology 医学-病理学
CiteScore
2.60
自引率
7.70%
发文量
163
审稿时长
3-6 weeks
期刊介绍: Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.
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