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Pleomorphic hyalinizing angiectatic tumor: cytomorphologic features on fine-needle aspiration
Ashley Cimino-Mathews1, Syed Z Ali
1Department of Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Diagnostic Cytopathology
|February 15, 2011
Summary
Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare neoplasm. Fine-needle aspiration revealed characteristic cytologic features, aiding in its diagnosis.
Area of Science:
- Surgical pathology
- Cytopathology
- Oncology
Background:
- Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, low-grade neoplasm.
- It predominantly affects the subcutaneous tissue of the lower extremities.
- Histological features include spindle cells, pleomorphic cells, ectatic vessels, fibrin, and hyalinization.
Observation:
- This report details the cytologic findings of PHAT via fine-needle aspiration (FNA) in a 46-year-old male with a right calf mass.
- FNA smears showed a cellular composition with predominantly bland spindle cells and a secondary population of pleomorphic spindle cells.
- Distinctive features included open chromatin in bland cells, coarse chromatin and prominent nucleoli in pleomorphic cells, intranuclear pseudoinclusions, and hyalinized vessels.
Findings:
- The cytologic diagnosis was "spindle cell lesion, NOS."
- Differential diagnoses included benign lesions, schwannoma, and PHAT.
- Absence of mitotic figures was noted.
Implications:
- Accurate cytologic diagnosis of PHAT is crucial for appropriate patient management.
- Recognizing the specific cytologic features of PHAT on FNA can help differentiate it from other spindle cell lesions.
- This case highlights the utility of FNA in evaluating soft tissue masses and guiding further diagnostic steps.
