Cytologically Yours: CoW: 20140227
Contents
Clinical Summary
The patient is a 74 year old female with a history of sarcoma of the right thigh and a new lung mass.
Past Medical History
- Sarcoma of thigh (3 years prior)
- Osteoarthritis
Past Surgical History
- Previous excision of thigh sarcoma.
- Hysterectomy
Radiology
- CT showed a right upper lobe low density nodule measuring 3.0 x 2.6 cm which is abutting the pleural surface.
Clinical Plan
The patient was scheduled for an endobronchial ultrasound guided fine needle aspiration biopsy.
Pathology
Cytology
20x magnification showing adipose tissue, atypical cells and bubbly appearing nuclei.
20x magnification showing adipose tissue
60x magnification showing bizarre appearing malignant cells with unusual bubbly nuclei and adjacent adipose tissue.
40x magnification showing bizarre appearing malignant cells with unusual bubbly nuclei and adjacent adipose tissue.
40x magnification showing bizarre appearing malignant cells with unusual bubbly nuclei and adjacent adipose tissue.
Final Diagnosis
Cytology
- Positive for malignancy, favor liposarcoma.
Biopsy
20x magnification of pleomorphic nuclei and lipoblasts.
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40x magnification of pleomorphic nuclei and lipoblasts.
Previous Soft Tissue Biopsy Diagnosis
- High grade pleomorphic liposarcoma.
Discussion
The diagnosis of pleomorphic liposarcoma on cytology rests on the presence of highly atypical, sometimes multinucleated lipoblasts. The scalloped nucleus is an important diagnostic feature.