Bronchioloalveolar carcinoma in progressive systemic sclerosis. Report of a case diagnosed by fine needle aspiration cytology.
BACKGROUND
Progressive systemic sclerosis (PSS) is a systemic disorder involving many internal organs, including the lungs. The occurrence of a pulmonary tumor has occasionally been reported, especially in long-standing cases. Bronchioloalveolar carcinoma is the most prevalent histologic type.


METHODS
A 35-year-old male with a 12-year history of PSS presented with exertional dyspnea and pain in the left side of the chest. Fine needle aspiration cytology (FNAC) showed abundant cellular material with large, monolayered sheets and papillary structures. The neoplastic cells had uniform round to oval nuclei and spacious cytoplasm. Some had intranuclear vacuoles. Phosphotungstic acid-hematoxylin (PTAH) stain revealed structures in the form of prominent cell membranes rimming the free surfaces of the tumor cells. The overall cytologic picture was interpreted as consistent with bronchioloalveolar carcinoma. The patient's condition did not permit surgery.


CONCLUSIONS
In this case the development of bronchioloalveolar carcinoma occurred over a 12-year period following the diagnosis of PSS. This case emphasizes diagnosis of the tumor solely by FNAC. PTAH stain was also helpful in the cytologic diagnosis.
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D001707:Biopsy, Needle; D001980:Bronchi / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D012595:Scleroderma, Systemic / Q000150:complications*