Esthesioneuroblastoma: cytologic features with differential diagnostic considerations.

A case of recurrent esthesioneuroblastoma was diagnosed by fine-needle aspiration of a midcervical mass. The cytologic features that characterize this uncommon neoplasm include uniform, small, round-to-oval cells with coarsely granular chromatin, multiple small nucleoli, prominent nuclear membranes, and scant cytoplasm. Morphologically and ultrastructurally, esthesioneuroblastoma cells resemble those of sympathetic neuroblastomas. Both tumors show rosette formation and minimal cellular pleomorphism, and, by electron microscopy, dense-core cytoplasmic granules can be identified. The cytologic recognition of esthesioneuroblastoma is important since it metastasizes to cervical lymph nodes accessible to fine-needle aspiration biopsy. In addition, the histogenesis of this unusual neuroectodermal tumor and its behavior are discussed.