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The Korean Journal of Pathology 2010;44(5): 558-563.
doi: https://doi.org/10.4132/KoreanJPathol.2010.44.5.558
The Fine Needle Aspiration Cytology of a Metastatic Pulmonary Adrenocortical Carcinoma Mimicking Primary Large Cell Carcinoma of the Lung.
Na Rae Kim, Dong Hae Chung, Jae Ik Lee, Seung Yeon Ha
1Department of Pathology, Gachon University Gil Hospital, Incheon, Korea. syha@gilhospital.com
2Department of Thoracic Surgery, Gachon University Gil Hospital, Incheon, Korea.
Adrenocortical carcinoma is a rare neoplasm and it has an invariably lethal prognosis. We report here on the fine needle aspiration cytologic findings of a solitary metastatic pulmonary adrenocortical carcinoma in a 24-year-old woman. The aspirate smears were very cellular and they were composed of a monomorphic population of large polyhedral cells with abundant granular or vacuolated cytoplasm, and the cells were predominantly singly scattered in a necrotic background. Multinucleated pleomorphic tumor cells were also found. Pleomorphic nuclei with thickened nuclear membranes were impinging on the cell membranes. Mitotic activity was occasionally seen. The cytologic findings of pleomorphic cells with microvacuolated cytoplasm and the presence of vague gland-like sheets, as well as the patient's history of undergoing adrenalectomy for primary adrenocortical carcinoma helped the pathologist reach the diagnosis of metastatic adrenocortical carcinoma. Here, we focus on the cytologic differential points of metastastic pulmonary adrenocortical carcinoma and primary pulmonary carcinoma, especially large cell carcinoma.
Key Words: Aspiration cytology; Adrenocortical carcinoma; Neoplasm metastasis; Carcinoma, large cell; Lung neoplasms