Metastatic alveolar rhabdomyosarcoma on the fine-needle aspiration cytology of cervical lymph node in an elderly patient, with FISH confirmation: A case report
- Author:
Zhao Zitong
1
Author Information
1. Department Of Anatomical Pathology, Division Of Pathology, Singapore General Hospital, Singapore
- Collective Name:Angela Takano; Alvin Soon Tiong Lim; Tse Hui Lim; Sathiyamoorthy Selvarajan
- Publication Type:Case Reports
- Keywords:
alveolar rhabdomyosarcoma;
lymph node metastasis;
fine-needle aspiration cytology
- From:The Malaysian Journal of Pathology
2020;42(1):115-119
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Alveolar rhabdomyosarcoma (RMS) usually occurs in adolescents and young adults, and most frequently arises in the extremities. Case Report: We present a rare case of metastatic alveolar RMS from a nasal primary to cervical lymph nodes (LNs) in an elderly patient, diagnosed on the fine-needle aspiration (FNA) biopsy. Smears showed malignant round cells featuring focal rhabdoid appearance, with rhabdomyoblastic differentiation further supported by immunocytochemical stains. Diagnosis of alveolar RMS was confirmed by fluorescence in situ hybridization (FISH) identifying FOXO1 gene involvement with dual colour break-apart probes at locus 13q14. Discussion: The differential diagnosis for a small round blue cell tumour in the elderly generally includes metastatic small cell carcinoma, lymphoma, malignant melanoma, RMS, desmoplastic small round cell tumour and Ewing’s sarcoma/primitive neuroectodermal tumour. Subtle morphological analysis and expression pattern of immunostaining for skeletal muscle differentiation led to the diagnosis of RMS. Cytogenetic testing on the FOXO1 gene rearrangement helps definite subtyping of alveolar RMS.
- Full text:5.2020my01051.pdf
