Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation

The rarity of Clear Cell Sarcoma (CCS) and its overlapping morphology with other soft tissue tumours brings diagnosis under suspicion. Several series have described histopathologic features however, only few series have described cytological features. This series represents cytohistopathological cor...

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Main Authors: Sheetal Arora, Geetika Khanna, Rajni, Deepshikha Rana
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2018-05-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/11544/29153_F(SHU)_PF1(MJ_AP)_PFA(MJ_AP)_PB(MJ_SS)_PN(SS).pdf
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author Sheetal Arora
Geetika Khanna
Rajni
Deepshikha Rana
author_facet Sheetal Arora
Geetika Khanna
Rajni
Deepshikha Rana
author_sort Sheetal Arora
collection DOAJ
description The rarity of Clear Cell Sarcoma (CCS) and its overlapping morphology with other soft tissue tumours brings diagnosis under suspicion. Several series have described histopathologic features however, only few series have described cytological features. This series represents cytohistopathological correlation with emphasis on diagnostic difficulties and the role of ancillary studies. This series concerns six patients who presented at our hospital between 2002-2012. FNAC smears showed epithelioid to spindle cells, scattered or in focal clusters or pseudoacinar pattern. Most cells (n=5) had round to oval eccentrically placed nuclei. Multinucleated tumour giant cells and binucleated cells were (n=2) present. The cell clusters (n=2) demonstrated three dimensional clustering and pseudoacinar structures. Necrosis (n=1) was noted. The histopathological pattern showed variable sized nests of uniform plump to spindle cells with clear to pale cytoplasm separated by fine to coarse fibrous septae. Cells were epithelioid (n=2), with nuclear pleomorphism (n=2), prominent nucleoli (n=3), cytoplasmic vacuoles (n=1) and multinucleated giant cells (n=1). The mitotic rate varied from 3 to 11/HPF. Tumour necrosis and bone involvement were seen (n=2). A microcystic growth pattern (n=1) was seen in the locally recurrent tumour. Melanin and Masson-Fontana were negative. All cases were positive for HMB-45 antibodies. Accurate pathologic recognition could aid in the institution of prompt surgery and could delay or avoid recurrences.
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spelling doaj.art-3bf92325bc3b4e29b6a0a828ccd5a9ac2022-12-21T20:06:17ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-05-01125ER01ER0510.7860/JCDR/2018/29153.11544Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological CorrelationSheetal Arora0Geetika Khanna1Rajni2Deepshikha Rana3Assistant Professor, Department of Pathology, VMMC and Safdarjung Hospital, New Delhi, Delhi, India.Professor, Department of Pathology, Central Institute of Orthopaedics VMMC and Safdarjung Hospital, New Delhi, Delhi, India.Professor, Department of Pathology, Central Institute of Orthopaedics VMMC and Safdarjung Hospital, New Delhi, Delhi, India.Assistant Professor, Department of Pathology, PGIMS, Rohtak, Haryana, India.The rarity of Clear Cell Sarcoma (CCS) and its overlapping morphology with other soft tissue tumours brings diagnosis under suspicion. Several series have described histopathologic features however, only few series have described cytological features. This series represents cytohistopathological correlation with emphasis on diagnostic difficulties and the role of ancillary studies. This series concerns six patients who presented at our hospital between 2002-2012. FNAC smears showed epithelioid to spindle cells, scattered or in focal clusters or pseudoacinar pattern. Most cells (n=5) had round to oval eccentrically placed nuclei. Multinucleated tumour giant cells and binucleated cells were (n=2) present. The cell clusters (n=2) demonstrated three dimensional clustering and pseudoacinar structures. Necrosis (n=1) was noted. The histopathological pattern showed variable sized nests of uniform plump to spindle cells with clear to pale cytoplasm separated by fine to coarse fibrous septae. Cells were epithelioid (n=2), with nuclear pleomorphism (n=2), prominent nucleoli (n=3), cytoplasmic vacuoles (n=1) and multinucleated giant cells (n=1). The mitotic rate varied from 3 to 11/HPF. Tumour necrosis and bone involvement were seen (n=2). A microcystic growth pattern (n=1) was seen in the locally recurrent tumour. Melanin and Masson-Fontana were negative. All cases were positive for HMB-45 antibodies. Accurate pathologic recognition could aid in the institution of prompt surgery and could delay or avoid recurrences.https://jcdr.net/articles/PDF/11544/29153_F(SHU)_PF1(MJ_AP)_PFA(MJ_AP)_PB(MJ_SS)_PN(SS).pdfhmb-45malignant melanomasoft tissue sarcoma
spellingShingle Sheetal Arora
Geetika Khanna
Rajni
Deepshikha Rana
Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation
Journal of Clinical and Diagnostic Research
hmb-45
malignant melanoma
soft tissue sarcoma
title Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation
title_full Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation
title_fullStr Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation
title_full_unstemmed Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation
title_short Difficulty in Cytological Diagnosis of Clear Cell Sarcoma - A Clinicopathological Correlation
title_sort difficulty in cytological diagnosis of clear cell sarcoma a clinicopathological correlation
topic hmb-45
malignant melanoma
soft tissue sarcoma
url https://jcdr.net/articles/PDF/11544/29153_F(SHU)_PF1(MJ_AP)_PFA(MJ_AP)_PB(MJ_SS)_PN(SS).pdf
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AT rajni difficultyincytologicaldiagnosisofclearcellsarcomaaclinicopathologicalcorrelation
AT deepshikharana difficultyincytologicaldiagnosisofclearcellsarcomaaclinicopathologicalcorrelation