title: Fine-needle aspiration diagnosis of a metastatic adult sclerosing rhabdomyosarcoma in a lymph node.
abstract: Adult sclerosing rhabdomyosarcoma (ASRMS) is a rare variant of rhabdomyosarcoma with a characteristic histological appearance of small, round cells in a dense, hyalinized stroma. Although nodal metastases of soft-tissue sarcomas are considered uncommon, up to 5% overall are associated with lymph node metastases. Nonetheless, there is little literature on the cytologic characteristics of metastatic soft-tissue sarcomas in lymph nodes, and to our knowledge, there are no reports of nodal metastasis of ASRMS diagnosed by fine-needle aspiration (FNA) cytology. We report here a 55-year-old woman who presented with a right thigh mass and associated ipsilateral inguinal lymphadenopathy. Biopsy of the mass revealed a uniform population of small, round cells in a dense, sclerotic background. A diagnosis of ASRMS was rendered. Subsequently, the patient underwent FNA of an enlarged inguinal lymph node, which revealed an identical population of small, round cells in a dense, myxoid background. This case highlights the cytologic features of a rare form of rhabdomyosarcoma, and emphasizes the utility of FNA in the assessment of lymphadenopathy in the setting of a soft-tissue sarcoma.
authors.affiliation: Department of Pathology, Rush University Medical Center, Chicago, Illinos 60612, USA. Richard_cantley@rush.edu
authors.forename: Richard L
authors.initials: RL
authors.lastname: Cantley
authors.forename: David
authors.initials: D
authors.lastname: Cimbaluk
authors.forename: Vijaya
authors.initials: V
authors.lastname: Reddy
authors.forename: Chiara
authors.initials: C
authors.lastname: Iacusso
authors.forename: Paolo
authors.initials: P
authors.lastname: Gattuso
mesh_terms: D044963:Biopsy, Fine-Needle; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D012208:Rhabdomyosarcoma / Q000556:secondary*; D012983:Soft Tissue Neoplasms / Q000473:pathology*