Pseudomalignant cytologic presentation of spermatic hydrocele fluid

An unusual cytologic presentation of spermatic hydrocele fluid is reported. The aspirate contained highly atypical cells, exhibiting marked anisocytosis and nuclear abnormalities strongly suggestive of cancer. On histologic examination the lesion displayed pseudosarcomatous fasciitis in the cyst wall and foci of atypical reactive mesothelial hyperplasia in the lining. This case illustrates a potential pitfall in the cytology of spermatic hydrocele fluid.