Pleomorphic rhabdomyosaroma diagnosed by fine needle aspiration cytology using the cell-transfer technique

Abstract

Background : Pleomorphic rhabdomyosaroma is a rare and highly malignant tumor that tends to occur in deep soft tissues of adults. Reports on the cytological features of pleomorphic rhabdomyosaroma have been limited.Case : An 84-year-old female complained of a 6-month tumor in her left forearm. The tumor was large (about 18 cm in long diameter), nodular, relatively hard, and immobile. The tumor exhibited iso-intensity and partially higher intensity to muscle on T1-weighted images, and mixture of higher intensity, iso-intensity and lower intensity to muscle on T2-weighted images. Fine needle aspiration cytology was carried out. The tumor showed high cellularity against a hemorrhagic background. The tumor cells were round, spindle and polygonal, and showed marked atypism and size variation. Many cells had cytoplasmic processes. The tumor cells were positive for myoglobin by immunocytochemistry after performing the cell-transfer technique. A diagnosis of pleomorphic rhabdomyosaroma was made by fine needle aspiration cytology using Papanicolaou staining and immunocytochemistry. The diagnosis was confirmed by core needle biopsy. Amputation was performed at the level above the elbow.Conclusion : Pleomorphic rhabdomyosaroma could be diagnosed by fine needle aspiration cytology using Papanicolaou staining and immunocytochemical analysis with multiple antibodies using the cell-transfer technique.