Barium sulfate crystals in a fine needle aspiration biopsy specimen from a neck mass in a patient with squamous cell carcinoma. A case report.

A fine needle aspirate of a neck mass in a 79-year-old man with a previous laryngectomy for squamous cell carcinoma was submitted for examination. In addition to cytologic findings of squamous cell carcinoma, there were numerous birefringent crystals of varying shapes and sizes. Energy dispersive x-ray analysis confirmed that these crystals were barium sulfate. Recognition of barium sulfate crystals in a fine needle aspiration or other cytologic specimens is important since barium granulomas may mimic neoplasms clinically. Barium sulfate may also indicate rupture of an organ or the presence of a fistula.