Cytologic features of malignant cystic pheochromocytoma: a case report.
BACKGROUND
Image-guided fine needle aspiration (FNA) biopsy of deep-seated lesions (e.g., retroperitoneal) has aided preoperative diagnosis and treatment planning. Fine needle aspiration biopsy of pheochromocytomas traditionally has been contraindicated by many authors because of possible hypertensive crisis and fatal hemorrhage. Cytologic features are described for a malignant pheochromocytoma (greater percentage of smaller cells and absence of hyaline globules) with extensive cystic degeneration that was later confirmed by histopathologic, immunohistochemical and ultrastructural studies.


METHODS
An elderly man was diagnosed with renal cell carcinoma based on clinical examination and ultrasonography. FNA performed on the mass revealed interesting features of pheochromocytoma with an abundance of small cells.


CONCLUSIONS
The cytopathologist should be aware of the cytologic features of pheochromocytoma so as to detect a clinically unsuspected lesion. An increased percentage of smaller cells may be indicative of aggressive tumors.
Niveditha
Shankaran Rukmini
SR
Department of Pathology, Kempegowda Institute of Medical Sciences, Bangalore, India. srniveditha@hotmail.com
Suguna
Belur Venugopal
BV
Krishnamurthy
Rajnikanth
Babu
Kudupadi Ganesh Sudharshan
KG
Shukla
Anil Kumar
AK
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D000313:Adrenal Medulla / Q000473:pathology*; D044963:Biopsy, Fine-Needle; D002292:Carcinoma, Renal Cell / Q000175:diagnosis*; D003560:Cysts / Q000473:pathology*; D003937:Diagnosis, Differential; D004386:Duodenum / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010235:Paraganglioma / Q000175:diagnosis*; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests