Merchant Shakil H
Department of Pathology, Pathology and Laboratory Medicine Service, New Mexico VA Health Care System, Albuquerque, New Mexico 87108, USA.
Acta Cytol. 2009 Nov-Dec;53(6):689-92. doi: 10.1159/000325411.
Low grade fibromyxoid sarcoma (LGFMS) is a rare tumor with a characteristic histologic appearance. Although the spectrum of histologic features that can be seen in LGFMS a well characterized, their description in the cytology literature is lacking.
A 57-year-old male with a past history of Hodgkin's lymphoma presented with 1-year history of dysphagia. Clinical examination and radiologic imaging studies revealed a neck mass suggestive of a thyroid lesion. Fine needle aspiration cytology of the mass revealed moderately cellular smears with several cohesive clusters. Most of the clusters showed cellular crowding with overlapping nuclei. The nuclei ranged from round to oval or elongated shapes with frequent irregular nuclear membranes, powdery to clear nuclear chromatin and inconspicuous nucleoli. Most notably, several intranuclear inclusions and nuclear grooves were noted, leading to a suggestion of a papillary thyroid carcinoma. Histopathologic examination of the mass revealed an LGFMS.
This report describes a rare case of LGFMS with epithelioid morphology. By virtue of its clinical presentation and cytologic features, the case masqueraded as a papillary thyroid carcinoma and should be added to the list of pitfalls in the diagnosis of papillary thyroid carcinoma. The case also serves to add to the spectrum of morphologic changes that can be seen in LGFMS.
低度恶性纤维黏液样肉瘤（LGFMS）是一种具有特征性组织学表现的罕见肿瘤。尽管LGFMS中可见的组织学特征范围已得到充分描述，但细胞学文献中对其描述尚缺。
一名有霍奇金淋巴瘤病史的57岁男性，出现吞咽困难1年。临床检查和影像学研究显示颈部肿块，提示甲状腺病变。对该肿块进行细针穿刺细胞学检查，结果显示涂片细胞中等量，有多个细胞黏附性团块。大多数团块显示细胞拥挤，细胞核重叠。细胞核形状从圆形到椭圆形或细长形不等，核膜常不规则，核染色质呈粉末状至透明状，核仁不明显。最值得注意的是，发现了几个核内包涵体和核沟，提示为甲状腺乳头状癌。对该肿块进行组织病理学检查，结果显示为LGFMS。
本报告描述了一例具有上皮样形态的罕见LGFMS病例。鉴于其临床表现和细胞学特征，该病例伪装成甲状腺乳头状癌，应列入甲状腺乳头状癌诊断中的陷阱清单。该病例也有助于丰富LGFMS中可见的形态学变化谱。
