A case report of small round cell tumor of palm: A difficult code to decipher on cytology.
Int J Surg Case Rep 2021;
89:106659. [PMID:
34890980 PMCID:
PMC8665336 DOI:
10.1016/j.ijscr.2021.106659]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/16/2021] [Accepted: 12/01/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction
Small round cell tumors (SRCT) are difficult to sub categorise on fine-needle aspiration cytology (FNAC) samples as they are rare and it is difficult for cytopathologists to obtain enough experience for rendering reliable diagnoses. Various sub categories of SRCTs are morphologically very similar. Many SRCTs do not have specific antigens which could be demonstrated with immunocytochemistry (ICC) or they lose them when poorly differentiated. Besides, cross-reactivity exists between some SRCTs. Suboptimal FNAC sampling from a heterologous component and unstandardized performance of ICC contributes to the pitfalls.
Presentation of the case
A 40-year-old male presented with a swelling measuring 3 cm in diameter on palmar aspect of right-hand. Magnetic resonance imaging suggested cyst of tendon sheath. However, on cytology in combination with ICC, a diagnosis of non-lymphoid small round cells tumor was suggested, with confirmatory diagnosis on histopathology.
Conclusion
FNAC assisted with ICC can be a rapid and economical diagnostic tool in cases of high-grade malignant tumors for which early diagnosis is extremely important.
Small round cell tumors (SRCT) are difficult to sub categorise on fine-needle aspiration.
Fine needle aspiration cytology (FNAC) of the palpable lesions is usually the first line of investigation in such cases.
Fine needle aspiration cytology alone is not diagnostic.
Fine needle aspiration cytology assisted with immunocytochemistry can be useful for rapid diagnosis.
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