Malignant hemangiopericytoma 穿刺吸引細胞診2症例による検討  [in Japanese] Malignant hemangiopericytoma. Studies on fine needle aspiration cytology in two cases.:Studies on fine needle aspiration cytology in two cases  [in Japanese]

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Zimmermannの血管周皮細胞から発生すると考えられているmalignant hemangiopericytomaの穿刺吸引細胞診2例を検討した.<BR>症例は, 36歳男性の左肩甲部軟部腫瘍と, 24歳女性の鼠径部腫瘍である. 細胞所見は, 2例とも基本的に同じであり, 均一な紡錘形細胞が多数の束状集塊として採取された. 集塊の中心には血管が存在し, これらの血管を取り巻くように核異型の弱い腫瘍細胞が,"柳の枝様" に配列していた. 病理組織所見は, 不規則な拡張を示しstaghorn様を呈する血管腔の周囲に, 紡錘形~楕円形の均一な腫瘍細胞が密に増生していた. 周囲への浸潤性増殖を伴っており, malignant hemangiopericytomaと診断された.<BR>この腫瘍は一般的に異型性が弱く, 良性・悪性の鑑別が問題になるとともに, pericytomapatternを示す悪性軟部腫瘍との鑑別も重要となるが, 臨床所見・細胞採取量・細胞配列などに着目すれば推定診断は可能と思われる.

This report is an attempt to deal with the diagnostic evaluation of malignant hemangiopericytoma by fine needle aspiration cytology. We recently experienced two cases of this disease, which is rather rare and is believed to originate in Zimmermann's pericytes. It is difficult to differentiate between benign and malignant forms, because the nuclear atypism of this tumor is usually slight. It is also difficult to distinguish malignant hemangiopericytoma from other soft tissue neoplasms with cell arrangements that mimic the pericytoma pattern.<BR>The two cases were in a 36-year-old male and a 24-year old female, and the tumors were located in the scapular region and the inguinal region, respectively. In both cases, the needle aspiration specimen of the tumor contained a large number of bundles of uniform spindle-shaped cells with mild nuclear atypia. Blood vessels were seen in the center of the bundles, and the tumor cells were clustered around vascular channels, revealing a “willow twig”-like pattern of cell arrangement.<BR>Histologically, the tumor was rich in irregulaly branching, blood vessels exhibiting a “staghorn”-like pattern. Uniform, oval to spindle-shaped tumor cells had proliferated around the vascular channels. However, the tumor cells exhibited invasive proliferation and a diagnosis of malignant hemangiopericytoma was made.<BR>Clusters of bundles of uniform spindle-shaped cells and a “willow twig” pattern of cell arrangement around the branching vascular channels are considered the cytological characteristics of malignant hemangiopericytoma.


  • The Journal of the Japanese Society of Clinical Cytology

    The Journal of the Japanese Society of Clinical Cytology 34(1), 98-102, 1995

    The Japanese Society of Clinical Cytology


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