A case of epithelioid sarcoma arising in the perineum. Imprint cytological study.
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Epithelioid sarcoma is a rare soft tissue tumor which occurs mainly in the finger, hand, and forearm of young adults. There have been only a few reports concerning the cytology of this sarcoma. We report a case of recurrent epithelioid sarcoma arising in the perineal region, with special reference to imprint cytology. A 45-year-old man visited a hospital complaining of a lump in the right perineal region four years earlier. The perineal mass ws resected. Half a year and 4 years after his initial operation, he suffered from repeated recurrences of the tumor in the same region. Imprint cytology of the recurrent tumor showed large ovoid or polygonal cells with scattered appearance or occasionally occurring in loosely connected clusters of the cells. The tumor cells possessed broad, deeply cyanophilic cytoplasm and round, slightly eccentric nuclei with one or two conspicuous nucleolei. Because of frequent appearance of rhabdoid cells and paucity of spindle cells, cytological differential diagnosis from a malignant rhabdoid cell tumor was difficult. Histologically, the tumor cells contained abundant eosinophilic cytoplasm occasionally showing rhabdoid features and proliferated in a nodular arrangement with a tendency toward central necrosis, leading to the diagnosis of epithelioid sarcoma. The tumor cells in the recurrent specimens, however, had a more prominent nucleolus than that of the initial specimens. Immunohistochemically, the tumor cells were reactive for epithelial membrane antigen, carcinoembryonic antigen, keratin, vimentin and CD 34. Electron microscopy revealed abundant intermediate filaments in the cytoplasm of the tumor cells. Although there is variety of tumors with rhabdoid features such as synovial sarcoma and rhabdoid tumor, it was considered that immunohistochemical examinations, including CD 34, were essential for making the diagnosis of epithelioid sarcoma in the present case.
- 特定非営利活動法人 日本臨床細胞学会の論文
特定非営利活動法人 日本臨床細胞学会 | 論文
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