Cytopathology of undifferentiated (embryonal) sarcoma of the liver

Abstract

We have studied one undifferentiated (embryonal) sarcoma of the liver (USL) by fine-needle aspiration cytology (FNAC) and have correlated the cytologic findings with those seen in the histologic sections. The main cytologic and immunocytochemical features were: cellular aspirates, mesenchymal clusters, disparity in individual cell size (small round cells, and multinucleated giant cells, sometimes bizarre), absence of biliary pigment, AFP-negative and vimentin-negative tumor cells, AFP-negative and PAS-positive hyaline globules, and apoptotic cells. Only immunostaining for alpha-1-antitrypsin, alpha-1-antichymotrypsin, and carcinoembryonic antigen were positive in tumor cells in histologic sections. The differential diagnosis should be carried out with rhabdomyosarcomas, hepatoblastomas, malignant fibrous histiocytomas, and poorly differentiated hepatocarcinomas. We think that the cytologic features observed in this case, evaluated both in the appropriate clinical context and in the light of the laboratory findings, may permit the correct diagnosis of this infrequent liver tumor. Nevertheless, more cases need to be studied to assess the reliability of our findings.

Hepatic Undifferentiated (Embryonal) Sarcoma: A Case Report With Fine Needle Aspiration Cytology and Histology

“…I t is noteworthy to m ention that there w ere extensiv e necrosis and marked acute in amm ation in the background of aspiration sm ears. Our ndings are sim ilar to those described by Sola-Perez et al [ 5] . W e think these cytologic features have recapitulated the characteristic histologic features of U ES, and F NA cou ld be used in future evaluation of suspected hepatic U ES.…”

“…H ow ever, because of the rarity of this tum or, the cytologic features are not very w ell described. To our know ledge, only tw o papers have been published on ne needle aspiration cytology of this rare neoplasm [ 4,5] . The cytopathologic features also have been described in peritoneal washing in a case w ith prim ary U ES [ 3] .…”

Fine needle aspiration cytology of undifferentiated embryonal sarcoma of the liver

“…The tumour cells have always been described as being of mesenchymal appearance with spindled and polygonal cells. Myxoid material has been found in a majority, 5–7 while giant cells with large bizarre nuclei have been a constant finding 3–8 . Arborizing vascular channels have been emphasized in two previous reports 4,5 .…”

“…The cytology of UESL is distinctive. Previous reports have usually found cellular aspirates, 4,5,7 although some have found bloody aspirates and many dissociated cells with few cellular clusters 6,8 . The tumour cells have always been described as being of mesenchymal appearance with spindled and polygonal cells.…”

“…Fine needle aspiration cytology (FNAC) diagnosis is therefore important. The cytological features are described in a few case reports where illustrations are not comprehensive 4–8 …”