Cytomorphologic Spectrum in Paraganglioma

Varma, Kachnar; Jain, Shyama; Mandal, Shramana

doi:10.1159/000325596

Cited by 29 publications

(27 citation statements)

References 12 publications

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“…Cytologic features of single cell, loose clusters and occasional acinar configuration of large, oval cells with round to oval nuclei, evenly dispersed chromatin, focally discrete nucleoli, moderate anisocytosis and anisonucleosis have been well described for paragangliomas. [123] In the present case in addition to the acinar and discrete arrangement of cells, smears also showed few large loose clusters of cells enveloped by thin vascular channels the so called zellballen pattern, a diagnostic feature on histopathology. Hence it is being documented.…”

Section: Introductionsupporting

confidence: 54%

Loose cell clusters with vascular coats: Zellballen pattern of paraganglioma on cytology

Jashnani

Patil

Balsarkar

2013

J Cytol

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Paragangliomas are uncommon tumors arising in paraganglion tissue, which is well represented in the head and neck. A correct pre-operative cytological diagnosis helps in planning early and optimal surgery. Cytologic features in carotid body tumor and extra adrenal paragangliomas have been well described and documented. In addition to the acinar and discrete arrangement of cells, smears also showed a few large loose clusters of cells enveloped by thin vascular channels-the so-called zellballen pattern, a diagnostic feature on histopathology. Zellballen pattern of paraganglioma on cytology is not a common finding and hence is being reported.

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Section: Introductionsupporting

confidence: 54%

Loose cell clusters with vascular coats: Zellballen pattern of paraganglioma on cytology

Jashnani

Patil

Balsarkar

2013

J Cytol

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“…A number of previous studies have identified that malignant paragangliomas have a tendency to exhibit necrosis inside the tumor and decreased endocrine granules in the cytoplasm (29,30). A Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) has been used to distinguish between malignant (PASS ≥4) and benign (PASS <4) tumors (30).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and surgical treatment of retroperitoneal paraganglioma: A single-institution experience of 34 cases

Zheng

et al. 2017

Oncology Letters

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The present study aimed at identifying the clinical, radiological and pathological characteristics of retroperitoneal paragangliomas, and determining the association between the tumor features and the prognosis of patients following surgery. A total of 34 patients with retroperitoneal paragangliomas, who underwent resection between November 1999 and December 2015, were included in the present retrospective study. The patients' demographics, clinical symptoms and signs, tumor functional status, surgical procedure, intraoperative results, tumor pathology, radiological results, and postoperative survival time were recorded and analyzed. Of the 34 patients, the most common type of presenting symptom was abdominal mass (46%), followed by hypertension (39%) and abdominal pain (32%). Functional tumors occurred in 20 patients (59%). Computed tomography (CT) and magnetic resonance imaging revealed soft-tissue masses, with marked enhancement in the arterial phase, indicative of retroperitoneal paragangliomas. The preoperative CT diagnostic accuracy rate between 2010 and 2015 was markedly improved, compared with that between 1999 and 2009. The tumors were primarily located close to the renal arteries and veins surrounding the abdominal aorta and inferior vena cava. With the exception of one malignant paraganglioma, the majority of paragangliomas were positive for chromogranin A, S-100 protein, vimentin and heat-shock protein 90, and exhibited decreased expression of Ki-67 antigen and insulin-like growth factor 2. All tumors were completely removed by surgery. Distant metastasis, but not tumor size, functional status and local invasion, was markedly associated with survival. The preoperative diagnostic accuracy rate of retroperitoneal paragangliomas may be improved by focusing on the predilection sites and CT characteristics. In addition, immunohistochemical markers were useful to determine tumor malignancy. Complete surgical resection was appropriate for all patients and postoperative survival time was identified to be associated with tumor metastasis.

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“…Varma et al . [10] have reported nuclear budding in 8 out of 12 cytologically diagnosed cases of PG.…”

Section: Discussionmentioning

confidence: 99%

“…It shows immunoreactivity for chromogranin, synaptophysin, neuron-specific enolase and S-100. [1015] Radioimaging studies like ultrasound, CT scan with enhancement, magnetic resonance imaging and vascular imaging studies; like Doppler ultrasound and selective digital subtraction angiography are useful adjuncts to cytomorphology. These studies help in exact localization of EAP and also define their relation with major blood vessels.…”

Section: Discussionmentioning

confidence: 99%

Cytomorphologic spectrum in aspirates of extra-adrenal paraganglioma

Handa

Kundu

Mohan

2014

J Cytol

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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.

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Cytomorphologic Spectrum in Paraganglioma

Cited by 29 publications

References 12 publications

Loose cell clusters with vascular coats: Zellballen pattern of paraganglioma on cytology

Loose cell clusters with vascular coats: Zellballen pattern of paraganglioma on cytology

Diagnosis and surgical treatment of retroperitoneal paraganglioma: A single-institution experience of 34 cases

Cytomorphologic spectrum in aspirates of extra-adrenal paraganglioma

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