Adenomatoid Tumor of Tunica Albuginea Mimicking Seminoma on Fine Needle Aspiration Cytology

Monappa, Vidya; Rao, Anjali; Krishnanand, Geetha; Mathew, Mary; Garg, Shveta

doi:10.1159/000325324

Cited by 15 publications

(10 citation statements)

References 10 publications

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“…[45–47] There are also rare reports of this type of background being identified in adenomatoid tumors. [48] In addition, seminomas can be seen in the absence of a tigroid background,[4950] and in one center’s experience, it was seen in less than 40% of seminomas on aspiration cytology. [51] In difficult cases, ancillary studies performed on the cytology material can help to subtype the type of tumor giving rise to the tigroid background.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic difficulties and pitfalls in rapid on-site evaluation of endobronchial ultrasound guided fine needle aspiration

2010

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Background:One of the novel techniques utilizing fine needle aspiration (FNA) in the diagnosis of mediastinal and lung lesions is the endobronchial ultrasound (EBUS)-guided FNA. In this study, we describe five cases which had a discrepancy between on-site evaluation and final diagnosis, or a diagnostic dilemma when rendering the preliminary diagnosis, in order to illustrate some of the diagnostic difficulties and pitfalls that can occur in EBUS FNA.Methods:A total of five EBUS FNA cases from five patients were identified in our records with a discrepancy between the rapid on-site evaluation (ROSE) and final diagnosis, or that addressed a diagnostic dilemma. All of the cases had histological confirmation or follow-up. The cytomorphology in the direct smears, cell block, and immunohistochemical stains were reviewed, along with the clinical history and other available information.Results:Two cases were identified with a nondefinitive diagnosis at ROSE that were later diagnosed as malignant (metastatic signet-ring cell adenocarcinoma and metastatic renal cell carcinoma (RCC)) on the final cytological diagnosis. Three additional cases were identified with a ROSE and final diagnosis of malignant (large cell neuroendocrine carcinoma (LCNEC) and two squamous cell carcinomas), but raised important diagnostic dilemmas. These cases highlight the importance of recognizing discohesive malignant cells and bland neoplasms on EBUS FNA, which may lead to a negative or a nondefinitive preliminary diagnosis. Neuroendocrine tumors can also be difficult due to the wide range of entities in the differential diagnosis, including benign lymphocytes, lymphomas, small and nonsmall cell carcinomas, and the lack of immunohistochemical stains at the time of ROSE. Finally, the background material in EBUS FNAs may be misleading and unrelated to the cells of interest.Conclusions:This study illustrates the cytomorphology of five EBUS FNA cases that address some of the diagnostic challenges witnessed while examining these specimens during ROSE. Many of the difficulties faced can be attributed to the baseline cellularity of the aspirates, the bronchial contamination, the difficulty identifying neoplasms with bland cytology, the wide spectrum of diseases that can occur in the mediastinum with overlapping cytomorphologic features, the mismatch between the background material and the cell populations present, and the overall unfamiliarity with these types of specimens.

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Section: Resultsmentioning

confidence: 99%

Diagnostic difficulties and pitfalls in rapid on-site evaluation of endobronchial ultrasound guided fine needle aspiration

2010

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“…Although typical of germinoma and related tumors (seminoma and dysgerminoma), a lace‐like, tigroid background can be seen in glycogen‐rich tumors that usually show clear cell morphology. It has been reported in clear renal cell carcinoma, clear cell carcinoma of the genital tract, glycogen‐rich squamous cell carcinomas, hyalinazing clear cell carcinoma of the salivary gland, round cell sarcomas, clear cell sarcoma, malignant melanoma, and adenomatoid tumor . PTPR shares with these neoplasms its clear cell morphology and PAS positive cytoplasmic granules …”

Section: Discussionmentioning

confidence: 98%

Cytologic features of papillary tumor of the pineal region: A case report showing tigroid background

Jiménez‐Heffernan

Bárcena

Gordillo

et al. 2016

Diagnostic Cytopathology

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Papillary tumor of the pineal region (PTPR) is a rare neuroepithelial tumor of the pineal region of adults. We herein describe on a 34-year-old female the cytologic features of a PTPR studied using Diff-Quik stain. The patient presented hydrocephalia secondary to a pineal tumor. During surgery an intraoperative pathologic consultation was requested. Smears were hypercellular with numerous papillary tissue fragments and single cells. Papillary fragments had an evident inner vascular core. Neoplastic cells displayed moderate pleomorphism, plasmocytoid morphology, and cytoplasmic fragility. The background had a foamy, lace-like, tigroid appearance. Pathologic analysis revealed morphologic and immunohistochemical features of PTPR. When evaluating smears of a pineal tumor in an adult, the presence of true papillary structures and numerous single cells should raise the possibility of PTPR. This is particularly useful during intraoperative pathologic evaluation since, on frozen sections, the epithelial morphology of the tumor may be misleading. The papillary morphology which gives name to this neoplams is best appreciated on squash smears. An interesting feature seen in the present case was a prominent tigroid background. This is a characteristic cytologic feature observed in Romanowsky-type stained smears of germinoma and related tumors. It can be seen in other clear cell, glycogen-rich tumors. PTPR shares with these neoplasms its clear cell morphology and PAS positive cytoplasmic granules. As seen from the present case, germinoma is not the only tumor of the pineal region that may show a tigroid background. Cytologic features of PTPR differ from those of germinoma allowing their distinction during intraoperative consultations. Diagn. Cytopathol. 2016;44:1098-1101. © 2016 Wiley Periodicals, Inc.

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“…The rest of cases underwent orchiectomy. Both Garg and Monappa established the diagnosis of seminoma preoperatively by FNAC [ 7 , 14 ], while Barry, Lee, and Evans described cases with ill-defined lesions and unclear borders between masses and the testis, which made the malignancy not be excluded [ 9 , 12 , 15 ]. In our present case, even if the tumor demonstrated unclear border with testis in ultrasonography and protruded into the testis parenchyma in operation, the testis and the epididymis were not involved.…”

Section: Discussionmentioning

confidence: 99%

Adenomatoid Tumor of the Tunica Albuginea in a Boy: A Case Report and Literature Review

Guo

Tian

Liu

et al. 2015

Case Reports in Urology

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Adenomatoid tumors (AT) are the most common paratesticular neoplasms and account for approximately 30% of all paratesticular masses. Most of them occur in the third or fourth decade and present as well-defined firm and painless masses. We report here a case of adenomatoid tumor from tunica albuginea. This patient is a 12-year-old boy with left testicular pain for 6 months. Scrotal ultrasonography revealed a solid mass of paratesticular origin. The histology and immunohistochemistry confirmed the final diagnosis. A right tumor resection was performed. Because of its rarity, the clinical and histopathologic appearance is seldom illustrated. Here we present a case report and a comprehensive literature review with the objective of providing useful information on this entity.

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Adenomatoid Tumor of Tunica Albuginea Mimicking Seminoma on Fine Needle Aspiration Cytology

Cited by 15 publications

References 10 publications

Diagnostic difficulties and pitfalls in rapid on-site evaluation of endobronchial ultrasound guided fine needle aspiration

Diagnostic difficulties and pitfalls in rapid on-site evaluation of endobronchial ultrasound guided fine needle aspiration

Cytologic features of papillary tumor of the pineal region: A case report showing tigroid background

Adenomatoid Tumor of the Tunica Albuginea in a Boy: A Case Report and Literature Review

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