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Establishment of a Primary Culture of Patient-derived Soft Tissue Sarcoma
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High grade endometrial stromal sarcoma on thinprep.

Paula S Ginter1, Edyta C Pirog1, Rana S Hoda1

  • 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York.

Diagnostic Cytopathology
|July 16, 2015
PubMed
Summary
This summary is machine-generated.

High grade endometrial stromal sarcoma (HGESS) metastasis in lymph nodes presents diagnostic challenges. Cytomorphology on ThinPrep (TP) and conventional smears (CS) are compared, showing similar features with subtle differences.

Keywords:
ThinPrependometrial stromal sarcomafine needle aspirationlymph node metastasis

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Area of Science:

  • Gynecologic Pathology
  • Cytopathology
  • Oncology

Background:

  • High grade endometrial stromal sarcoma (HGESS) is a rare malignancy recently redefined in the WHO classification.
  • Metastatic HGESS in lymph nodes poses diagnostic challenges, especially in fine needle aspiration (FNA) specimens.
  • Understanding cytomorphological differences between ThinPrep (TP) and conventional smears (CS) is crucial for accurate diagnosis.

Purpose of the Study:

  • To discuss the differential diagnoses of metastatic HGESS in lymph node FNA.
  • To compare the cytomorphology of HGESS in ThinPrep (TP) versus conventional smears (CS).
  • To highlight diagnostic considerations for metastatic HGESS in lymph node aspirates.

Main Methods:

  • Analysis of fine needle aspiration (FNA) lymph node specimens from a patient with a history of stage I HGESS.
  • Comparison of cytomorphological features of HGESS cells in Diff-Quik (DQ) and Papanicolaou (Pap)-stained smears (conventional smears, CS).
  • Evaluation of HGESS cell morphology in ThinPrep (TP) preparations.
  • Consideration of differential diagnoses including lymphoma, metastatic spindle cell tumors, and metastatic carcinoma.

Main Results:

  • HGESS cells in lymph node FNA showed a monomorphic population of plump to oval cells with scant cytoplasm, fine chromatin, and inconspicuous nucleoli.
  • Cytomorphology in TP showed similar features to CS, with slightly smaller, hyperchromatic nuclei and attenuated chromatin pattern.
  • In the absence of clinical history, differentiating metastatic HGESS from other malignancies in lymph node FNA can be difficult.

Conclusions:

  • Cytomorphology of HGESS on TP correlated well with CS, with noted differences in nuclear size, hyperchromasia, and chromatin detail.
  • Immunohistochemical analysis and comparison with the primary tumor are valuable for confirming the diagnosis of metastatic HGESS.
  • Accurate cytopathological evaluation and ancillary studies are essential for diagnosing metastatic HGESS in lymph nodes.