title: Cytology of sclerosing epithelioid fibrosarcoma in pleural effusion.
abstract: We report a case of sclerosing epithelioid fibrosarcoma focusing on its cytological features in pleural effusion. A 32-year-old man had noticed a tumor in his left buttock 5 years earlier but had not sought treatment because the tumor had been painless. He visited our hospital because the tumor had gradually increased in size. The resected tumor was 12 × 8 × 6 cm in size and had a delineated margin. The histological diagnosis was sclerosing epithelioid fibrosarcoma with a negative surgical margin. Multiple tumor nodules were recognized in both lungs 9 months after the initial surgery, and an excisional biopsy was performed. A histological examination revealed a metastasis of sclerosing epithelioid fibrosarcoma, and chemotherapy was initiated. Pleural disseminations were detected 4 years after the chemotherapy, and the pleural effusion was sampled for cytological examination. The cytological examination revealed several medium-sized cell clusters with moderate overcrowding and an epithelioid cell arrangement; numerous histiocytes and lymphocytes and a small amount of mesothelial cells were observed in the background. The nuclei were pleomorphic with oval, spindle, or cleaved shapes and occasional multinucleation; they were located eccentrically in the cytoplasm and exhibited uniformly fine granular chromatin, a thin nuclear membrane, and several small nucleoli. The above cytological features, coupled with the clinical findings, enabled a diagnosis of sclerosing epithelioid fibrosarcoma. To our knowledge, this is the first cytological description of sclerosing epithelioid fibrosarcoma.
authors.affiliation: Department of Clinical Laboratory, Seirei Hamamatsu General Hospital, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tsuchido
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamada
authors.forename: Tamami
authors.initials: T
authors.lastname: Satou
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Otsuki
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D002081:Buttocks / Q000473:pathology; D003581:Cytodiagnosis; D015622:Epithelioid Cells / Q000473:pathology; D005354:Fibrosarcoma / Q000378:metabolism / Q000556:secondary*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D016066:Pleural Effusion, Malignant / Q000378:metabolism / Q000473:pathology*; D012598:Sclerosis / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000556:secondary