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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 2 4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 ,多形性大核细胞 (91 3% ) ,核仁明显 (6 9 5 % ) ,单核瘤巨细胞 (76 % ) ,多核瘤巨细胞 (6 5 2 % ) ,核分裂象 (36 9% ) ,出血、坏死 (93 4% )。骨巨细胞瘤以多核巨细胞 (10 0 % )、无多型性大核细胞 (87 5 % )为主要成分。骨转移性癌则以无多形性大核细胞 (10 0 % )、核仁明显 (75 % )、有核分裂象为主要特征。三者均有出血、坏死。骨肉瘤的细胞学诊断与组织学对照符合率为 93 4% ,骨巨细胞瘤为 87 5 % ,骨转移性癌为 91 6 %。结论 :这种方法简便快速而准确 ,结合临床和X线检查对于骨肿瘤术前诊断有重要意义 ,可作为术前常规检查的手段之一。
Objective: To investigate the diagnostic criteria of needle aspiration cytology in bone tumors. Methods: 46 cases of osteosarcoma needle aspiration cytology smears, and with 24 cases of giant cell tumor of bone and 12 cases of metastatic bone cancer control to find the cytological characteristics of osteosarcoma and histological control analysis. RESULTS: Ten cytological changes were observed in osteosarcoma: in osteosarcoma smear, pleomorphic macrophages (91.3%), clear nucleoli (655%), mononuclear giant cells (76% ), Multinucleated giant cell (65.2%), mitosis (36.9%), hemorrhage and necrosis (93.4%). Giant cell tumor of giant polygonal giant cells (10 0%), no polymorphic large nucleated cells (87 5%) as the main component. Bone metastatic cancellous non-polymorphous nucleated cells (10 0%), prominent nucleoli (75%), mitotic figures as the main features. All three have bleeding, necrosis. The cytological diagnosis of osteosarcoma and histological control coincidence rate was 93.4%, giant cell tumor of bone was 87.5%, 91.6% of bone metastatic cancer. Conclusion: This method is simple, rapid and accurate. Combined with clinical and X-ray examination is of great significance for the preoperative diagnosis of bone tumors and can be used as one of the routine preoperative examination methods.