Fine-needle aspiration cytology of clear-cell sarcoma of the kidney: study of eight cases.

Abstract:

:The largest series, to date, of fine-needle aspiration cytology (FNAC) findings in clear-cell sarcoma of the kidney (CCSK) is presented. All fine-needle aspirates of pediatric renal masses over a 17-yr period were reviewed. Eight out of 119 aspirates from late-stage childhood renal tumors (6.72%) were found to be CCSK. Ten aspirates from these eight patients and histopathological confirmation in six patients were available. Aspirates were cellular with three cell types: cord cells, septal cells, and small pyknotic cells. Cord cells, seen in all aspirates, were large polygonal cells with abundant eccentrically placed wispy cytoplasm, round to oval nuclei, and fine dusty chromatin. Occasional bare nuclei and frequent nuclear grooves were also seen. Small pyknotic cells were a degenerative change identified in 9 out of 10 aspirates. Stromal fragments with branching vascular cores were seen in 8 out of 10 aspirates, 6 of which had myxoid substance surrounding the vessel. Septal cells were spindle shaped and usually embedded in the stromal fragments. On the basis of cytology and histology, cases were classified into classical CCSK (5 cases), spindle-cell CCSK (1 case), and anaplastic CCSK (2 cases). Classical CCSK showed mostly cord cells with few stromal fragments. Spindle-cell CCSK showed preponderance of myxoid stromal fragments and septal cells. Anaplastic CCSK showed bizarre pleomorphic nuclei, coarse chromatin, and atypical mitosis. Cytology of CCSK is a spectrum with varying proportions of cord cells, septal cells, and mucopolysaccharide substance. Anaplastic CCSK is liable to misdiagnosis as Wilms tumor (WT) with unfavourable histology. Presence of eccentric cytoplasm in cord cells and nuclear grooves are the key to differentiation from Wilms tumor, including anaplastic variants.

journal_name

Diagn Cytopathol

journal_title

Diagnostic cytopathology

authors

Iyer VK,Agarwala S,Verma K

doi

10.1002/dc.20317

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

83-9

issue

2

eissn

8755-1039

issn

1097-0339

journal_volume

33

pub_type

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