Endoscopic ultrasound-guided fine needle aspiration diagnosis of metastatic sex cord tumor with annular tubules: A case report

Abstract

The cytologic findings of a paratracheal metastasis from a malignant sex cord tumor with annular tubules (SCTATs) diagnosed by endoscopic ultrasound guided fine needle aspiration are described. Cytologic features of SCTATs include the presence of highly cellular aspirates forming simple and complex rosette-like structures around central rounded hyaline material, small nucleoli, and prominent nuclear grooves. These cytologic findings are clearly distinct from the poorly formed rosette-like structures of granulosa-cell tumors and are reminiscent of the low-power appearance of the cribriform variant of adenoid cystic carcinoma. The fine needle aspiration cytologic features of only two other cases have been previously described and, to the best of our knowledge, this is the first case reporting the cytologic diagnosis of a distant metastasis of a SCTATs by endoscopic ultrasound-guided fine needle aspiration. In this case, the distinctive and characteristic cytologic features have allowed the proper diagnosis of a distant metastasis of SCTATs.

Cytological aspects of an ovarian sex cord tumour with annular tubules

“…To date, previous reports of SCTATs by fine needle aspiration commonly demonstrated two‐dimensional rosette‐like clusters with central hyaline bodies similar to Call‐Exner body‐like rosettes in granulosa‐cell tumours (GCT) . In our case, the tumour cells in the ascitic smears were usually arranged as two‐layered cohesive spherical clusters.…”

Adult granulosa cell tumor of the ovary: Fine‐needle‐aspiration cytology of 10 cases and review of literature

“…Proliferating Brenner Tumor and SCTAT have small nucleoli, which can be helpful in differentiating from AGCT. 32,33 Immunohisto-chemistry, as demonstrated by some studies, can also be useful in the differential diagnosis since AGCT is immunoreactive for Inhibin and CD99. 34,35 The epithelial nests of Brenner tumor are immunoreactive for cytokeratin and epithelial membrane antigen, which can help in the diagnosis.…”

“…SCTAT is mainly differentiated on the basis rosettes, with or without a central acellular core comprising of basement membrane material. 33 The rosettes observed in SCTAT are three dimensional with greater cellularity than that seen in Call-Exner bodies of AGCT. In addition, the luminal material in Call-Exner bodies is less defined than in the rosettes of SCTAT.…”

“…In addition, the luminal material in Call-Exner bodies is less defined than in the rosettes of SCTAT. 33 Occasionally, AGCT with a diffuse pattern can be mistaken for a poorly differentiated carcinoma. The nuclear appearance can be very helpful for differentiating the two entities.…”

Cytologic features of needle aspiration of ovarian sex cord tumor with annular tubules: Report of two cases and literature review

“…Clinical presentations include irregular vaginal bleeding, hyperestrinism, and the presence of an abdominal/pelvic mass. Although histopathologic features of this tumor have been well described, only few case reports discuss cytologic features . Herein, we report two cases of ovarian SCTAT with cyst aspiration and summarize the cytologic features.…”