Cytomorphologic spectrum in aspirates of extra-adrenal paraganglioma

Abstract

Background:Paraganglioma is a rare tumor arising from clusters of neuroendocrine cells in association with sympathetic and parasympathetic nervous system. It poses a diagnostic challenge because of its widespread anatomic distribution, subtle clinical manifestations, and a variety of morphologic patterns.Aim:The aim of this study is to have an insight into the diverse morphologic spectrum of extra-adrenal paraganglioma (EAP).Materials and Methods:A retrospective analysis of seven cytologically diagnosed cases of EAP over a period of 10 years was performed. There were five superficial swellings and two deep seated retroperitoneal masses. The superficial swellings were aspirated directly, and the retroperitoneal masses were aspirated under ultrasound guidance using 22-gauge lumbar puncture needle fitted to a 10 mL syringe. Smears were reviewed for cellularity, pattern, cell shape, cytoplasm, nuclear features, and background.Results:The age of patients ranged from 25 to 75 years; four patients were males and three were females. Sites involved were carotid body region (four cases), para-pharyngeal space (one case) and para-aortic region (two cases). All the cases yielded hemorrhagic material on fine-needle aspiration. Smears showed scattered and clusters of cells and loosely cohesive acini of tumor cells. Cells were round to polygonal with pleomorphic nuclei, granular chromatin, inconspicuous nucleoli, and moderate to abundant cytoplasm containing fine pink granules and vacuolations. The cases were confirmed on radiology and histopathology.Conclusion:The cytologic features in EAP along with pertinent clinicoradiologic findings help in making an accurate preoperative diagnosis of an otherwise rare tumor.

The Application of the Proposed Sydney System for Reporting Lymph Node Cytopathology: A Five-Year Experience of an Academic Institution in South India

“…This was a case of metastatic paraganglioma, wherein the high cellularity with acinar formations of the oval to round pleomorphic cells in a hemorrhagic background was misinterpreted as metastatic carcinoma, Figure 7. A few studies have highlighted the difficulty in distinguishing retroperitoneal paraganglioma from adrenal cortical carcinomas, renal cell carcinoma, and metastatic adenocarcinoma [20]. The sensitivity and specificity of FNAB of lymph nodes fall well within that reported by other studies which vary from 75% to 99% and 87% to 100%, respectively, Table 5.…”

Incidental Cytodiagnosis of Carotid Body Tumour on Fine Needle Aspiration Cytology

“…These cases were sent for fine needle aspiration cytology much before the radio imaging investigation such as ultrasonography, color doppler, CT, or MRI. The present case was one like the above situation where the patient was referred for fine needle aspiration cytology before being investigated radiologically [ 1 , 4 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

“…They are rare neck tumors confused with a cervical neck mass and form a wide clinical differential diagnosis. The incidence is around 0.3 per 100,000 population and 0.5% of total head and neck masses [ 1 ]. The cells of carotid body tumors are neuroendocrinal by function and possess chemoreceptors.…”

“…The cells of carotid body tumors are neuroendocrinal by function and possess chemoreceptors. Fine needle aspiration cytology diagnosis of carotid body tumors is infrequently reported in the literature [ 1 , 2 , 3 ].…”