title: Clear-cell sarcoma diagnosis by fine-needle aspiration: cytologic, histologic, and ultrastructural features; potential pitfalls; and literature review.
abstract: A definitive diagnosis of clear-cell sarcoma of soft parts (CCSSP) is possible by fine-needle aspiration (FNA) biopsy alone. The aspirates are markedly cellular, consisting predominantly of discohesive cells but also of cohesive cells. The cytoplasm is eosinophilic and eccentric. The nuclei are round and contain macronucleoli. CCSSP should be considered when FNA of a soft-tissue tumor shows uncharacteristically high cellularity and relatively uniform cells with macronucleoli. Cohesion of some tumor cells does not rule out CCSSP. Melanin pigment and cytoplasmic clearing are infrequent and not necessary for the diagnosis. Sufficient material should always be procured for immunohistochemical studies on the cell block. Seven other cases are found in the literature, all correctly diagnosed by FNA. Although it is rare, CCSSP is a highly malignant tumor that can be diagnosed readily by FNA without resorting to incisional biopsy.
authors.affiliation: Department of Pathology, Room G-1414, Princess Margaret Hospital, Kowloon, Hong Kong SAR, People's Republic of China. tommy.tong@graduate.hku.hk
authors.forename: Tommy R
authors.initials: TR
authors.lastname: Tong
authors.forename: Tat-chong
authors.initials: TC
authors.lastname: Chow
authors.forename: Olivia Wai-hing
authors.initials: OW
authors.lastname: Chan
authors.forename: Kam-cheong
authors.initials: KC
authors.lastname: Lee
authors.forename: Sai-hung
authors.initials: SH
authors.lastname: Yeung
authors.forename: Angus
authors.initials: A
authors.lastname: Lam
authors.forename: Chi-kin
authors.initials: CK
authors.lastname: Yu
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D002467:Cell Nucleus / Q000473:pathology; D003593:Cytoplasm / Q000648:ultrastructure; D017809:Fatal Outcome; D015726:Giant Cells / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D018227:Sarcoma, Clear Cell / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure; D012983:Soft Tissue Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D009418:S100 Proteins