The Fine Needle Aspiration Cytology of a Metastatic Pulmonary Adrenocortical Carcinoma Mimicking Primary Large Cell Carcinoma of the Lung
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Adrenocortical carcinoma is a rare neoplasm and it has an invariably lethal prognosis. We report here on the fine needle aspiration cytologic findings of a solitary metastatic pulmonary adrenocortical carcinoma in a 24-year-old woman. The aspirate smears were very cellular and they were composed of a monomorphic population of large polyhedral cells with abundant granular or vacuolated cytoplasm, and the cells were predominantly singly scattered in a necrotic background. Multinucleated pleomorphic tumor cells were also found. Pleomorphic nuclei with thickened nuclear membranes were impinging on the cell membranes. Mitotic activity was occasionally seen. The cytologic findings of pleomorphic cells with microvacuolated cytoplasm and the presence of vague gland-like sheets, as well as the patient’ history of undergoing adrenalectomy for primary adrenocortical carcinoma helped the pathologist reach the diagnosis of metastatic adrenocortical carcinoma. Here, we focus on the cytologic differential points of metastastic pulmonary adrenocortical carcinoma and primary pulmonary carcinoma, especially large cell carcinoma.
Abstract
Adrenocortical carcinoma is a rare neoplasm and it has an invariably lethal prognosis. We report here on the fine needle aspiration cytologic findings of a solitary metastatic pulmonary adrenocortical carcinoma in a 24-year-old woman. The aspirate smears were very cellular and they were composed of a monomorphic population of large polyhedral cells with abundant granular or vacuolated cytoplasm, and the cells were predominantly singly scattered in a necrotic background. Multinucleated pleomorphic tumor cells were also found. Pleomorphic nuclei with thickened nuclear membranes were impinging on the cell membranes. Mitotic activity was occasionally seen. The cytologic findings of pleomorphic cells with microvacuolated cytoplasm and the presence of vague gland-like sheets, as well as the patient’ history of undergoing adrenalectomy for primary adrenocortical carcinoma helped the pathologist reach the diagnosis of metastatic adrenocortical carcinoma. Here, we focus on the cytologic differential points of metastastic pulmonary adrenocortical carcinoma and primary pulmonary carcinoma, especially large cell carcinoma.
참고문헌 (12)
- Kopf D, "Clinical management of malignant adrenal tumors", J Cancer Res Clin Oncol, 127, pp.143~155 (2001)
- Medeiros LJ, "Adrenal gland: tumors and tumor-like lesions. In: The difficult diagnosis in surgical pathology", pp.377~407 (1996), WB Saunders
- Khan JH, "Pulmonary metastases of endocrine origin:the role of surgery", Chest, 114, pp.526~534 (1998)
- Fulmer BR, "Diagnosis and management of adrenal cortical carcinoma", Curr Urol Rep, 8, pp.77~82 (2007)
- Pilotti S, "Fine needle aspiration biopsy cytology of primary and metastatic pulmonary tumors", Acta Cytol, 26, pp.661~666 (1982)
- Dhawan SB, "Adrenocortical carcinoma:diagnosis by fine needle aspiration cytology", Indian J Pathol Microbiol, 47, pp.44~45 (2004)
- Weiss LM, "Pathologic features of prognostic significance in adrenocortical carcinoma", Am J Surg Pathol, 13, pp.202~206 (1989)
- Ren R, "Fine-needle aspiration of adrenal cortical carcinoma:cytologic spectrum and diagnostic challenges", Am J Clin Pathol, 126, pp.389~398 (2006)
- van Slooten H, "Morphologic characteristics of benign and malignant adrenocortical tumors", Cancer, 55, pp.766~773 (1985)
- Krishnamurthy S, "Fine-needle aspiration cytology of a case of oncocytic adrenocortical carcinoma", Diagn Cytopathol, 22, pp.299~303 (2000)
- Serrano R, "Fine needle aspiration cytology of metastatic hepatic adrenocortical carcinoma mimicking hepatocellular carcinoma:a case report", Acta Cytol, 45, pp.768~770 (2001)
- Hiroshima K, "Cytological characteristics of pulmonary large cell neuroendocrine carcinoma", Lung Cancer, 48, pp.331~337 (2005)