Fine‐needle aspiration diagnosis of a metastatic adult sclerosing rhabdomyosarcoma in a lymph node

Abstract

Adult sclerosing rhabdomyosarcoma (ASRMS) is a rare variant of rhabdomyosarcoma with a characteristic histological appearance of small, round cells in a dense, hyalinized stroma. Although nodal metastases of soft-tissue sarcomas are considered uncommon, up to 5% overall are associated with lymph node metastases. Nonetheless, there is little literature on the cytologic characteristics of metastatic soft-tissue sarcomas in lymph nodes, and to our knowledge, there are no reports of nodal metastasis of ASRMS diagnosed by fine-needle aspiration (FNA) cytology. We report here a 55-year-old woman who presented with a right thigh mass and associated ipsilateral inguinal lymphadenopathy. Biopsy of the mass revealed a uniform population of small, round cells in a dense, sclerotic background. A diagnosis of ASRMS was rendered. Subsequently, the patient underwent FNA of an enlarged inguinal lymph node, which revealed an identical population of small, round cells in a dense, myxoid background. This case highlights the cytologic features of a rare form of rhabdomyosarcoma, and emphasizes the utility of FNA in the assessment of lymphadenopathy in the setting of a soft-tissue sarcoma.

Sclerosing Rhabdomyosarcoma: Report of a Case Arising in the Head and Neck of an Adult and Review of the Literature

“…Clinicopathologic and molecular genetic characterization of additional cases may help resolve how to classify this lesion in the future. Table 2 Summary of clinicopathologic data for 39 reported cases (including the current case) of sclerosing rhabdomyosarcoma [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Feature …”

“…These authors reported a series of unusual rhabdomyosarcoma cases, exhibiting prominent hyaline sclerosis and a pseudovascular growth pattern. Additional cases have been reported since in both adult and pediatric patients, with a marked predilection for the extremities and head and neck region [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Here we report a new case of SRMS, centered within the pterygomaxillary fossa of an adult male.…”

Sclerosing Rhabdomyosarcoma: Presentation of a Rare Sarcoma Mimicking Myoepithelial Carcinoma of the Parotid Gland and Review of the Literature

“…Figure 4a, b summarize key epidemiologic features of this rare variant [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The most common sites of presentation of SRMS are the extremities and the head and neck (Fig.…”

Needle biopsy of mesenchymal lesions of the head and neck: Evolving concepts and new strategies for diagnosis

“…The cytologic features of SR have not been well characterized, and descriptions of the FNA findings of this tumor have been confined to case reports. 27,28 Aspirates of SR tend to be modestly cellular comprising fairly monotonous cells with ovoid to spindled configuration. Cytoplasm tends to be absent or indistinct, and stromal material may or may not be present (Fig.…”