Pitfalls in Fine Needle Aspiration Cytology of Extraadrenal Paraganglioma

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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“…These studies help in exact localization of EAP and also define their relation with major blood vessels. [41617]…”

Section: Discussionmentioning

confidence: 99%

Cytomorphologic spectrum in aspirates of extra-adrenal paraganglioma

Handa

Kundu

Mohan

2014

J Cytol

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“…ithelioid to spindle cells that may be uniform or variably pleomorphic, [11][12][13][14][15][16][17] and distinction from MTC, melanoma, neurogenic tumors, sarcoma and metastatic carcinoma may be difficult on purely cytomorphologic grounds. 15,18 FNAC specimens from intrathyroidal PG may be nondiagnostic or misinterpreted as MTC. 5,6 In the present case, however, the converse occurred and the PG-like variant of MTC was mistaken for a primary intrathyroidal PG.…”

Section: To the Editorsmentioning

confidence: 99%

Cytologic, Histologic and Immunocytochemical Features in Fine Needle Aspiration of Paraganglioma-like Variant of Medullary Carcinoma

Jayaram¹,

Hayati²,

Yip³

et al. 2008

Acta Cytologica

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“…Although FNA has been considered a contraindication in PC because of potential risk of hypertensive crisis, there are reports in which it has been diagnosed incidentally on FNA without complications. Cytologic features of PG have been highlighted in only a few studies [3][4][5][6][7][8][9][10][11][12][13] and textbooks. 14 The present study included clinically unsuspected cases of PG, in which FNA suggested its possibility.…”

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confidence: 99%