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                                                           Interesting Case

 Contributors:

Dorota E. Rudomina, MBA, CT (ASCP)

Chad DeFrain, MD

Memorial Sloan-Kettering Cancer Center, New York, New York

Clinical history:

A 34 year old man presented to our institution complaining of the recent development of a nodule in the left side of his neck. The nodule was painless and there was no associated weight loss, fever, or night sweats.  Several years prior, he had undergone a wide local excision of a benign fibrous histiocytoma of the lower extremity.  On examination, the cervical nodule measured 2 cm in diameter and appeared to be confined within the substance of the left sternocleidomastoid muscle. There was no associated cervical or supraclavicular lymphadenopathy. A fine needle aspiration biopsy of the mass was performed, followed by a wide local excision.

Figure 1 (Pap Stain, 200X)	Figure 2 (Pap Stain, 400X)
Figure 3 (Pap Stain, 200X)	Figure 4 (Pap Stain, 200X)

Cytologic findings:

The aspirated material was hypercellular with cells dispersed predominantly as single forms. Some compact, cohesive aggregates were also noted (Figure 1).  The cells were spindle shaped and contained a small to moderate amount of pale staining, homogeneous, nonvacuolated and nonpigmented cytoplasm. The cytoplasm extended from cell nuclei as short unipolar or bipolar processes (Figure 2).  The nuclei were oval to markedly elongated with finely granular chromatin and smooth nuclear contours (Figure 3). Nucleoli were prominent. Numerous multinucleated giant cells were also observed in the cytologic specimen (Figure 4).  Small fragments of collagenous stroma were scattered throughout the smear.

 Cytologic diagnosis: Click here!