Figure 2 (H&E, 100X)
Figure 3 (H&E, 400X)
Figure 4 (Pap, 400X)
March Interesting Case
Contributor:
Maria A. Friedlander, MPA, CT (ASCP)
Memorial Sloan-Kettering Cancer Center, New York, New York
Clinical history:
A 70 year old female patient presented with a right renal mass and an adrenal
lesion 2 years prior. At that time, the decision was made to follow her with
observation only. Two years later, follow-up radiologic exams revealed that both
renal and adrenal masses had increased in size. Two pleural based masses were
also noted. The patient was presumed to have metastatic renal cell carcinoma. A
fine needle aspiration (FNA) of the renal lesion was taken to confirm the
diagnosis but was non-diagnostic. A FNA and core needle biopsy of the adrenal
lesion was subsequently obtained.
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Figure 2 (H&E, 100X) |
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Figure 3 (H&E, 400X) |
Figure 4 (Pap, 400X) |
Cytologic findings:
The specimen was very cellular and contained both isolated and loosely cohesive
groups of small and large polygonal cells. (Figure 1) The cells had a fair
amount of delicate, granular cytoplasm. (Figure 2) Many stripped nuclei were
noted in the background. (Figure 3) The nuclei were round and varied in size.
The chromatin was finely granular and evenly distributed. Some nuclei had a more
“salt and pepper” type chromatin, characteristic of neuroendocrine tumors.
(Figure 4) Prominent nucleoli were also occasionally noted.
Cytologic diagnosis: read on!