|
|
-Case Reports-
Exfoliation of Alveolar Rhabdomyosarcoma Cells in the Ascites of a 50-Year-Old Woman: Diagnostic Challenges and Literature Review
1Department of Diagnostic Pathology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
2Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
3Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
4Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan
Alveolar rhabdomyosarcoma (ARMS) is a nonepithelial tumor with skeletal muscle differentiation and typically affects adolescents and young adults. The cytological features of ARMS in body fluid have not been well characterized, which complicates diagnosis. Here, we describe the cytological features of ARMS in the ascites of a 50-year-old woman with an intra-abdominal mass and abundant ascites. Aspiration cytology of ascitic fluid revealed numerous small discohesive round cells with mild nuclear atypia and prominent nucleoli. Rhabdomyoblastic cells, characteristic of rhabdomyosarcoma, were identified rarely. Cannibalism and 'window' formation, as seen in reactive mesothelial cells, complicated the diagnosis of ARMS. Histological examination established the diagnosis of ARMS, which was confirmed by immunohistochemical expression of myogenic markers. When diagnosing ARMS from effusion samples, the diagnostic problems associated with the morphological similarity of ARMS cells to reactive mesothelial cells should be considered.
J Nippon Med Sch 2019; 86: 236-241
Keywords
alveolar rhabdomyosarcoma, ascites, cytology, mesothelial cells, myogenin
Correspondence to
Norio Motoda, MD, PhD, Department of Diagnostic Pathology, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
n-motoda@nms.ac.jp
Received, October 25, 2018
Accepted, January 22, 2019
PDF (2,211K)