title: Fine needle aspiration cytology in diagnosis of metastatic sebaceous gland carcinoma of the eyelid to the lymph nodes with clinicopathological correlation.
abstract: OBJECTIVE
  The diagnosis of metastasis to the lymph node, especially with an inconspicuous primary lesion, poses a challenge to clinicians as well as to pathologists. We report the cytologic findings of sebaceous gland carcinoma (SGC) of the eyelid metastatic to the lymph node with confirmation by oil red O stain whenever required.
  
  
  METHODS
  We reviewed cases and slides with cytologic diagnosis of metastatic SGC in lymph nodes.
  
  
  RESULTS
  Fifteen patients presented with metastasis to the preauricular (n = 15), submandibular (n = 6) and anterior cervical nodes (n = 3). The mean age was 56.4 years and the male:female ratio was 2:3. The upper lid was involved in 53.3% of cases. Fine needle aspiration cytology performed on the lymph nodes showed large polygonal cells with abundant vacuolated cytoplasm, numerous histiocytes and fat globules in the background. Oil red O staining was performed on air-dried smears in 7/15 cases and showed bright orange positivity in intracytoplasmic vacuoles and extracytoplasmic globules, confirming metastasis from SGC. Tissue was obtained from eyelid lesions for histopathologic diagnosis in 12 out of 15 cases. Out of 12 patients, 7 showed pagetoid spread at the primary site, with the tumor showing moderate differentiation in 6 cases.
  
  
  CONCLUSIONS
  Cytologic diagnosis of metastatic SGC is straightforward in most cases; however, use of oil red O stain supports the diagnosis, especially in cases with a silent primary tumor site.
authors: Ophthalmic Pathology Laboratory, L.V. Prasad Eye Institute, Hyderabad, India.
authors: Shilpa
authors: S
authors: Goyal
authors: Santosh G
authors: SG
authors: Honavar
authors: Milind
authors: M
authors: Naik
authors: Geeta K
authors: GK
authors: Vemuganti
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D003581:Cytodiagnosis; D003584:Cytological Techniques; D005142:Eyelid Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012626:Sebaceous Gland Neoplasms / Q000556:secondary*