Cytologie des tissus mous et des os Flashcards
Lésion des tissus mous
Lipome
Benign lipomas have occasional capillaries, but they are not as numerous as in hibernomas (Papanicolaou stain).
Lésion des tissus mous
Hibernome
(A) Delicate capillaries (arrows) can be numerous and are closely associated with tumor cells that have distinct granular and multivacuolated cytoplasm (Papanicolaou stain). (B) Lipoblast-like cells are present, but the nuclei are small and lack atypia (Papanicolaou stain).
FNA d’une lésion du rétropéritoine
Liposarcome bien différencié
The much-touted variation in adipocyte size can be subtle and easily overlooked (compare with Fig. 17.1) (Papanicolaou stain).
The enlarged, hyperchromatic nuclei of lipoblasts are scalloped because of multiple impinging cytoplasmic lipid droplets (Papanicolaou stain).
Atypical nuclei in deep-seated fatty lesions denote malignancy, even when classic lipoblasts are not readily identified (Papanicolaou stain).
FNA d’une lésion des tissus mous
Liposarcome pléomorphe
FNA d’une lésion intra-musculaire
Myxome intra-musculaire
(A) Many Intramuscular myxomas are paucicellular, comprised mostly of myxoid matrix. Rare macrophages and bland spindle cells are present (Papanicolaou stain). (B) Cellularity is more pronounced with a cellular myxoma. Stubby vessels can be seen, especially with the cellular myxoma (Romanowsky stain).
FNA d’une lésion des tissus mous
Myxofibrosarcome
(A) The vascular component, when present, manifests itself as short curvilinear segments of thick-walled vessels with adherent matrix and pleomorphic tumor cells (Papanicolaou stain). (B) Pseudolipoblasts (arrow) contain acid mucins rather than lipid (Romanowsky stain).
Tissus mous
Liposarcome myxoïde
(A) Discrete tissue fragments contain myxoid matrix, vessels, and tumor cells (Romanowsky stain). (B) Delicate branching “chicken-wire” capillaries are easily obtained by aspiration and are seen in abundance on smears (Papanicolaou stain). (C) The lipoblasts in myxoid liposarcomas resemble signet-ring cells and histiocytes and are often associated with the vessels (Romanowsky stain).
FUS-DDIT3
Tissus mous
Liposarcome myxoïde
(A) Discrete tissue fragments contain myxoid matrix, vessels, and tumor cells (Romanowsky stain). (B) Delicate branching “chicken-wire” capillaries are easily obtained by aspiration and are seen in abundance on smears (Papanicolaou stain). (C) The lipoblasts in myxoid liposarcomas resemble signet-ring cells and histiocytes and are often associated with the vessels (Romanowsky stain).
FUS-DDIT3
Tissus mous
Chondrosarcome myxoïde extra-squelettique
(A) The extraskeletal myxoid chondrosarcoma has a distinctive fibrillary chondromyxoid matrix (Romanowsky stain). (B) Long cytoplasmic extensions link one cell to another, often conferring a lacelike appearance (Papanicolaou stain).
Tissus mous
Léiomyosarcome
(A) Spindle cells are packed in cohesive tissue fragments with well-circumscribed, rigid edges (Romanowsky stain). (B) Nuclei are hyperchromatic, with finely textured chromatin in lower-grade tumors and more coarsely clumped chromatin in the higher-grade neoplasms (Papanicolaou stain).
Tissus mous
Schwannome
(A) Smears often contain thick tissue fragments that appear densely cellular, erroneously suggesting a sarcoma (Papanicolaou stain). (B) The neoplastic cells have abundant filamentous cytoplasm and an oval, curved, or wavy nucleus (Romanowsky stain).
Tissus mous
Sarcome synovial
There is a distinctive pattern of dispersed cells alternating with cohesive cell clusters (Papanicolaou stain).
Synovial Sarcoma, Biphasic. Epithelial differentiation is recognized as only a vague palisading of nuclei along the edges of tissue fragments or as clusters of more epithelioid-appearing cells among the spindle cells (Papanicolaou stain).
Synovial Sarcoma, Monophasic. (A) The oval to round nuclei are remarkably uniform, although rare elongated, blunt-ended, and bent forms are seen (Papanicolaou stain).
Tissus mous
Tumeur fibreuse solitaire
(A) Cellular fragments with a meshwork of irregular fascicles alternate with isolated spindle-shaped cells (Papanicolaou stain).
(B) High magnification reveals collagen fibers coursing through the tumor (Papanicolaou stain).
(C) Cell block preparations are very helpful for capturing the characteristic bland, monomorphic spindle-shaped cells insinuated between collagen bundles (hematoxylin and eosin stain).
Tissus mous
Petite lésion
(A) Smears can be cellular, with numerous myofibroblasts embedded in a myxoid matrix (Romanowsky stain).
(B) Dispersed, polymorphic myofibroblasts are characteristic (Romanowsky stain).
(C) The myxoid matrix is less conspicuous with the Papanicolaou stain.
(D) Mitoses are not unusual (Romanowsky stain).
Tissus mous, gaine tendineuse
Tumeur à cellules géantes ténosynoviales
(A) Mononuclear histiocytoid cells are arranged in clusters. There is prominent intracytoplasmic hemosiderin, imparting a speckled, ladybug-like appearance to the cells (Papanicolaou stain).
(B) Multinucleated giant cells are a prominent feature (Romanowsky stain).
Tissus mous
Goutte
(A) The sample is comprised of innumerable needle-shaped crystals in a background of granular debris (Papanicolaou stain).
(B) Examination under polarized light demonstrates the crystals more clearly.
Tissus mous
Tumeur à cellules granulaires
Small nuclei within abundant granular cytoplasm result in a low nuclear-to-cytoplasmic ratio (Papanicolaou stain).
Tissus mous
Tumeur à cellules granulaires
Small nuclei within abundant granular cytoplasm result in a low nuclear-to-cytoplasmic ratio (Papanicolaou stain).
Tissus mous
Élastofibrome
Sharply defined, hypocellular fragments contain rare bland fibroblasts with curvilinear, rodlike elastic fibers (hematoxylin and eosin stain).
Tissus mous
Amyloïdome
Fragments of waxy, amorphous material have sharply defined edges with embedded fibroblasts and capillaries (Papanicolaou stain).
Os
Gauche : enchondrome
Fragments of mature cartilage with small, uniform chondrocytes in lacunae are well appreciated with air-dried, Romanowsky-stained smears.
Droite : chondrosarcome G1
B) Extracellular chondroid material from an atypical cartilaginous tumor/grade 1 chondrosarcoma is indistinguishable from that seen in enchondromas (Romanowsky stain).
Os
En haut : chondrosarcome G2-3
(A) Grade 2 and 3 chondrosarcomas yield cellular smears and prominent myxoid matrix (Romanowsky stain).
(B) Cytologic atypia is apparent. The chondromyxoid matrix is paler and less conspicuous with alcohol-fixed smears (Papanicolaou stain).
En bas : chondrosarcome dédifférencié
Dedifferentiated chondrosarcoma has a sarcomatous component that is indistinguishable from a spindle-cell/pleomorphic sarcoma. The scant chondromyxoid matrix seen here is relatively nonspecific but might spur a search for better differentiated areas (Romanowsky stain).
Os
En haut : chondrosarcome G2-3
(A) Grade 2 and 3 chondrosarcomas yield cellular smears and prominent myxoid matrix (Romanowsky stain).
(B) Cytologic atypia is apparent. The chondromyxoid matrix is paler and less conspicuous with alcohol-fixed smears (Papanicolaou stain).
En bas : chondrosarcome dédifférencié
Dedifferentiated chondrosarcoma has a sarcomatous component that is indistinguishable from a spindle-cell/pleomorphic sarcoma. The scant chondromyxoid matrix seen here is relatively nonspecific but might spur a search for better differentiated areas (Romanowsky stain).
Os
Tumeur à cellules géantes de l’os
(B) Large clusters of mononuclear stromal cells are admixed with numerous osteoclast-like giant cells, many arranged at the periphery of the clusters of stromal cells (arrows) (Romanowsky stain).
(C) The giant cells are distributed evenly within the stromal cells on cell block sections (hematoxylin and eosin stain).
Os
Chordome
Clusters of large, round to cuboidal “physalliferous” cells are embedded in a rich myxoid matrix (Romanowsky stain). Tumors cells show strong nuclear staining for brachyury (inset).
Os
Plasmacytome
(A) A Dispersed population of recognizably plasmacytoid cells is common. Binucleation is often seen (arrows) (Romanowsky stain).
Os
Histiocytose à cellules de Langerhans
(B) Neoplastic Langerhans cells can be epithelioid or elongated (“dendritic”) in appearance. Many nuclei are markedly folded and grooved (arrows).
