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Diagnose von Weichteiltumoren in der Zytologie

Cytologic diagnosis of soft tissue tumors

  • Schwerpunkt: Zytopathologie
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Zusammenfassung

Weichteilschwellungen sind das Symptom einer Vielzahl von neoplastischen und nichtneoplastischen Veränderungen. Sarkome gehören zu den selteneren Ursachen. Die Feinnadelpunktion hat sich in der Abklärung von Tumorrezidiven und Karzinommetastasen als minimal-invasive, kostengünstige und zuverlässige Methode bewährt. Auch in der Abklärung von Weichteiltumoren kann sie zu einer präzisen Diagnose führen. Voraussetzung ist eine enge multidisziplinäre Zusammenarbeit unter Einbeziehung klinischer, radiologischer und morphologischer Befunde. Für die zytologische Befundung sind Alter und Geschlecht sowie Topographie, Größe und Wachstumsgeschwindigkeit des Tumors wichtige Parameter. Reifungsgrad und Form der Zellen sowie Vorhandensein und Ausdifferenzierung der bindegewebigen Matrix bieten erste differenzialdiagnostische Hinweise und sind der Ausgangspunkt für immunzytochemische und molekularbiologische (FISH, RT-PCR) Zusatzuntersuchen. Diese Untersuchungen werden an Direktausstrichen, an mittels Zellblockmethode eingebettetem und an tiefgefrorenem Punktionsmaterial ausgeführt.

Abstract

Soft tissue swellings represent common clinical signs of a variety of neoplastic and non-neoplastic lesions. Sarcomas are rarely the cause. Fine needle biopsy as a minimally invasive, economic and accurate method is well suited for the diagnostics of recurrent and metastatic diseases. Cytologic diagnosis of primary soft tissue tumors is also feasible but requires close collaboration with other medical disciplines and incorporation of clinical, radiological and morphologic findings. Clinical data such as age, gender, size and topography are also important parameters. Differentiation of the cells and the properties of the extracellular matrix offer initial indications for the differential diagnosis and are the starting point for immunohistochemical and molecular analyses (FISH, RT-PCR). These analyses can be performed on cytological smears, on paraffin-embedded cell blocks on snap frozen material.

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  1. Abteilung Zytopathologie,Institut für Klinische Pathologie, Universitätsspital Zürich, Schmelzbergstraße 12, CH-8091, Zürich, Schweiz

    B. Bode-Lesniewska

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Bode-Lesniewska, B. Diagnose von Weichteiltumoren in der Zytologie. Pathologe 28, 368–376 (2007). https://doi.org/10.1007/s00292-007-0928-4

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  • DOI: https://doi.org/10.1007/s00292-007-0928-4

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