Fine needle aspiration cytology of adrenocortical oncocytic neoplasm: a case report.
BACKGROUND
Adrenocortical oncocytic neoplasms (AONs) are rare tumors that typically show marked nuclear pleomorphism and eosinophilic cytoplasm and are highly cellular on fine needle aspiration (FNA) smears. These features, worrisome in conventional adrenocortical tumors, are not necessarily signs of malignancy in AONs.


METHODS
A 64-year-old woman presented with 3 months of abdominal pressure. Computed tomography showed a 10-cm, solid, left adrenal mass and a 21-cm complex cystic mass in the pelvis. FNA of the adrenal mass showed hypercellular smears with dyscohesive cells having pleomorphic nuclei and abundant, granular cytoplasm. The lesion was initially interpreted as malignant. Resection of the adrenal mass demonstrated an AON without definite malignant features. The pelvic mass revealed bilateral ovarian cellular fibromas. Seventeen months of postoperative follow-up were uneventful.


CONCLUSIONS
On FNA, cells from an AON can be hypercellular and cytologically atypical, which can be pitfalls for a malignant diagnosis. Our case is the first reported in which an AON presented with ovarian cellular fibromas. To our knowledge, there is no association between the 2 lesions. We review criteria to classify benign vs. malignant AONs and discuss the literature on this topic.
Cham
Elaine
E
Department of Pathology, McGaw Medical Center of Northwestern University-Evanston Hospital, and NorthShore University HealthSystem, Evanston, Illinois, USA.
Watkin
William
W
Goldschmidt
Robert
R
Liu
Lin
L
D018249:Adenoma, Oxyphilic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D044963:Biopsy, Fine-Needle; D005260:Female; D005350:Fibroma / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010051:Ovarian Neoplasms / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome