Recurrent multifocal adult rhabdomyoma diagnosed by fine‐needle aspiration cytology: Report of a case and review of the literature

Abstract

The fine needle aspiration (FNA) cytology of a recurrent multifocal extracardiac adult rhabdomyoma is described, and the literature is reviewed. The patient presented with dysphagia and bilateral palpable neck masses 21 yr after resection of a rhabdomyoma of the tongue. The clinical differential diagnoses included ptotic submandibular glands and lymphadenopathy. The aspiration smears and cytospin preparations contained large polygonal cells with abundant granular cytoplasm with indistinct borders and uniform, peripherally located nuclei. Cross-striations were identified within the cytoplasm of some cells on Papanicolaou and modified Wright-Giemsa stains. This case represents only the fourth description of the cytology of this entity and the first reported case of a recurrence diagnosed by FNA. The characteristic cytomorphologic features enabled a definitive diagnosis to be made 21 yr after the original resection, sparing a poor-risk patient a debilitating surgical procedure for a benign, slow-growing neoplasm.

Adult Rhabdomyoma in Fine Needle Aspirates

“…2,6 Granular cell tumor (GCT) is mentioned as one of the main elements in the differential diagnosis in previous reports of the cytology of ARh. [1][2][3][5][6][7][8][9][10] As noted by Tani et al 8 and as we observed in 10 aspirates of GCT at our department, 4 the cell borders of ARh are distinct as compared to the diffuse borders of cells from GCT. The cells of ARh are also considerably larger than those from GCT.…”

“…[1][2][3][5][6][7][8][9][10] In most of these reports the cytologic features of ARh are described as rather characteristic, provided that an adequate smear is obtained. 1,3,5,[7][8][9][10] FNA smears of ARh, however, must be differentiated from those of other tumors or reactive conditions that yield granular cells in aspirates. 2,6 Granular cell tumor (GCT) is mentioned as one of the main elements in the differential diagnosis in previous reports of the cytology of ARh.…”

Fine‐needle aspiration of adult rhabdomyoma: A case report with review of the literature

“…Usually adult rhabdomyomas occur as a solitary mass, although they can at times occur as multiple nodules in the same anatomic location. 2,7 Afflicted patients present with symptoms of obstruction of the aerodigestive tract, including hoarseness or difficulty with breathing or swallowing.…”

“…Although histologic features of rhabdomyomas based on tissue sections have been well described, only several case reports [1][2][3][4][5][6][7] have described the cytologic features of adult rhabdomyoma seen with fine-needle aspiration (FNA). We present a case in which cytologic findings obtained by FNA were used to make the initial diagnosis.…”

Cytoarchitectural Findings in the Diagnosis of Primary Soft Tissue Tumors

“…Multinucleated cells are often observed. 18,40,159,167 Special techniques elicit intense reactivity for desmin, actin and myoglobulin, 159,167 and electron microscopy reveals thick and thin filaments and rudimentary sarcomeres. 167 …”