Authors: |
Conway, A. B.; Hart, M. K.; Jessurun, J.; Pambuccian, S. E. |
Article Title: |
"Cannonballs" and psammoma bodies: unusual cytologic features of metastatic pulmonary small-cell carcinoma in a pleural effusion |
Abstract: |
Large three-dimensional cell aggregates and psammoma bodies are usually encountered in benign serous effusions (mesothelial hyperplasia and endosalpingiosis), mesotheliomas, and metastatic papillary carcinomas. We report a case of pulmonary small-cell carcinoma occurring in an 88-year-old woman that initially presented with a malignant pleural effusion characterized cytologically by a predominance of large three-dimensional neoplastic cell aggregates ("cannonballs"), associated with rare psammoma bodies. Although the crowded three-dimensional tumor-cell aggregates did not allow detailed cytologic examination, the diagnosis of metastatic small-cell carcinoma could be established noting the characteristic chromatin features of the occasional single neoplastic cells and the characteristic "cell-in-cell" and "stack-of-coins" arrangements of rare small clusters of neoplastic cells. Immunoperoxidase stains showing positivity of the tumor cells for CD56, synaptophysin, and TTF1 further supported this diagnosis. Endobronchial ultrasound-guided fine-needle aspiration of a mediastinal lymph node subsequently confirmed the diagnosis of pulmonary small-cell carcinoma. Metastatic pulmonary small-cell carcinoma should be considered in the differential diagnosis of serous effusions showing large three-dimensional neoplastic cell aggregates and psammoma bodies to prevent a potential diagnostic pitfall. |
Journal Title: |
Diagnostic cytopathology
|
Volume: |
41 |
Issue: |
3 |
ISSN: |
1097-0339; 1097-0339 |
Publisher: |
Unknown
|
Journal Place: |
United States |
Date Published: |
2013 |
Start Page: |
247 |
End Page: |
252 |
Language: |
eng |
DOI/URL: |
|
Notes: |
CI: Copyright (c) 2011; JID: 8506895; 2011/04/11 [received]; 2011/05/31 [accepted]; 2011/10/11 [aheadofprint]; ppublish |