Periosteal Myxoid Leiomyosarcoma Histologically Mimicking Extraskeletal Myxoid Chondrosarcoma: Report of a Case with Histopathological and Cytopathological Comparison with Extraskeletal Myxoid Chondrosarcoma
| Autor: | Tatsuya Aso, Masanobu Eguchi, Kazuhiko Yuzawa, Jun-ichi Kawano, Wataru Fujinuma, Tsuyoshi Ishida, Toru Motoi, Yoshinao Kikuchi, Asako Yamamoto, Shiori Watabe, Hiroshi Uozaki, Kenji Sato |
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| Rok vydání: | 2021 |
| Předmět: |
Leiomyosarcoma
Pathology medicine.medical_specialty Histology medicine.diagnostic_test business.industry Soft tissue Chromogenic in situ hybridization General Medicine Extraskeletal Myxoid Chondrosarcoma medicine.disease Pathology and Forensic Medicine Cytopathology Biopsy medicine Immunohistochemistry business Myxoid Leiomyosarcoma |
| Zdroj: | Acta Cytologica. 65:541-548 |
| ISSN: | 1938-2650 0001-5547 |
| Popis: | Myxoid leiomyosarcoma (MLS) is a rare variant of leiomyosarcoma, with most cases occurring in the uterus. A case of MLS arising in the periosteal region of the tibia, mimicking extraskeletal myxoid chondrosarcoma (EMC), is described. The evaluation included histological and cytological comparison with EMC. The patient was a 77-year-old man with a palpable mass at the anterior aspect of the right lower leg. After diagnosis by cytopathology and biopsy examination, a wide resection was performed. The resulting cytological smears were composed primarily of spindle-shaped tumor cells in a myxoid and hemorrhagic background. Histologically, the tumor showed abundant myxoid matrix and tumor cells proliferating in a cord-like to reticular pattern, exhibiting a lace-like arrangement that mimicked EMC. Although immunohistochemical findings suggested leiomyosarcoma, a diagnosis of EMC eventually was excluded by the lack of a split signal when assessed for a rearrangement of NR4A3 by chromogenic in situ hybridization. Despite histological similarity to EMC, characteristic cytological findings of EMC such as epithelioid structures with a cord-like pattern and chondroblast-like lacunar structures were not observed in the smears of this patient’s MLS. We propose that cytopathological examination of bone and soft tissue lesions is useful as a diagnostic tool in similar cases. A total diagnostic workup, including clinical, radiographic, cytopathological, histopathological, and molecular findings, is needed to ensure an accurate final diagnosis and to reduce diagnostic error. |
| Databáze: | OpenAIRE |
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