Fine-needle aspiration of dedifferentiated chondrosarcoma of the larynx.
We present a case of dedifferentiated chondrosarcoma of the larynx in which the dedifferentiated component was initially diagnosed by fine-needle aspiration (FNA). The patient was a 74-yr-old man who presented with difficulty breathing and an anterior neck mass. A CT scan demonstrated a 4.5-cm cartilaginous lesion involving the left thyroid cartilage, with an anterior soft-tissue component. Nine years prior, the patient had an incomplete resection of a low-grade chondrosarcoma at the same site. FNA was performed on the current lesion, demonstrating a high-grade spindle-cell sarcoma with a storiform pattern. The cytomorphology together with immunocytochemistry and electron microscopy were diagnostic of malignant fibrous histiocytoma (MFH), and synthesis of the clinical, radiographic, and cytomorphologic features resulted in a diagnosis of dedifferentiated chondrosarcoma. The cytologic diagnosis was histologically confirmed by laryngectomy. Although rare, dedifferentiated chondrosarcoma should be included in the differential diagnosis of high-grade sarcomas of bone and cartilage assessed by FNA.
Faquin
W C
WC
Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. wfaquin@partners.org
Pilch
B Z
BZ
Keel
S B
SB
Cooper
T L
TL
D000368:Aged; D001707:Biopsy, Needle; D002813:Chondrosarcoma / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male