Adrenal cortical cells mimicking small cell anaplastic carcinoma in a fine-needle aspirate

Fine-needle aspiration of an adrenal mass was performed to rule out metastatic disease in a patient with a bronchogenic carcinoma. The aspiration was misinterpreted as metastatic small cell anaplastic carcinoma. Review of the aspirate by the authors revealed the atypical small cells to be aggregates of bare nuclei of benign adrenocortical cells. Interpretation of these bare nuclei in isolation and unfamiliarity with the aspiration cytology of the adrenal gland led to the initial misdiagnosis.