Paraganglion cells mimicking metastatic clear cell carcinoma

Four patients are presented whom normal paraganglion cells simulated metastases of clear cell carcinomas of the urogenital tract. The cells, located within and near the lumbar sympathetic ganglia, were initially interpreted by the pathologist as metastatic, but a later examination showed them to be normal paraganglion cells. One ganglion was also examined electron microscopically. Normal ganglion cells were seen, as were cells with intracytoplasmic osmophilic neurosecretory granules, confirming their paraganglionic origin. Awareness of the appearance of paraganglion cells in some instances is essential to avoid their misinterpretation as metastases of clear cell carcinomas.