Dermawan Josephine Kamtai, Doxtader Erika, Chute Deborah J, Policarpio-Nicolas Maria Luisa
Department of Pathology, Cleveland Clinic, Cleveland, Ohio, 44194.
Diagn Cytopathol. 2018 May;46(5):419-424. doi: 10.1002/dc.23860. Epub 2017 Nov 12.
Adult extracardiac rhabdomyomas are rare benign mesenchymal tumor arising from skeletal muscle. While they are often located in the larynx and pharynx, the incidence in the parapharyngeal area is extremely rare with only 1 documented cytology case report to date. We report a case of an adult extracardiac rhabdomyoma in the parapharyngeal space diagnosed cytologically with subsequent histologic confirmation. The patient is a 57-year-old man with history of weight loss, hematuria, dysphagia, and airway encroachment. Computerized tomography of his abdomen showed a large left renal mass. While the patient was in the operating room for the resection of his renal mass, a fine-needle aspiration from left the parapharyngeal mass was performed. The smears showed uniform bland polygonal cells with abundant eosinophilic cytoplasm and peripherally located nuclei. Immunohistochemical stains performed on the cell block showed the tumor cells were desmin positive and negative for S-100 and PAX-8, supporting the diagnosis of an adult rhabdomyoma. Subsequent resection of the mass confirmed the diagnosis of an adult extracardiac rhabdomyoma.
成人心脏外横纹肌瘤是一种罕见的起源于骨骼肌的良性间叶组织肿瘤。虽然它们常位于喉和咽,但咽旁区域的发病率极低,迄今为止仅有1例经细胞学记录的病例报告。我们报告1例经细胞学诊断并随后经组织学证实的咽旁间隙成人心脏外横纹肌瘤病例。患者为一名57岁男性,有体重减轻、血尿、吞咽困难和气道受压病史。其腹部计算机断层扫描显示左肾有一个大肿块。当患者在手术室进行肾肿块切除时,对左侧咽旁肿块进行了细针穿刺抽吸。涂片显示细胞形态一致、温和的多边形细胞,胞质丰富嗜酸性,细胞核位于周边。对细胞块进行的免疫组织化学染色显示肿瘤细胞结蛋白阳性,S-100和PAX-8阴性,支持成人横纹肌瘤的诊断。随后对肿块的切除证实了成人心脏外横纹肌瘤的诊断。