Low-grade endometrial stromal sarcoma presenting as multiple pulmonary nodules: A potential pitfall in fine needle aspiration and core biopsy specimens - A Cytological - Pathological Correlation

Ann Diagn Pathol. 2018 Oct:36:38-43. doi: 10.1016/j.anndiagpath.2018.06.004. Epub 2018 Jun 30.

Abstract

Low-grade endometrial stromal sarcoma (LGESS) is the second most common malignant mesenchymal tumor of the uterus. The most common location is the uterine corpus, but it can also primarily arise in a variety of extrauterine locations such as pelvis, ovary, abdominal cavity, vagina, and vulva. We are reporting a case of a 47-year-old female with no significant medical history who presented with multiple pulmonary nodules. Fine needle aspiration (FNA) specimen revealed spindle cell neoplasm consistent with the diagnosis of LGESS. The differential diagnosis included neuroendocrine tumor, synovial sarcoma, solitary fibrous tumor, smooth muscle tumors, and peripheral nerve sheath tumors. The clinical, cytological, and histopathologic details of this case, as well as a discussion of the potential pitfalls and differential diagnosis of spindle cell lesions of the lung are described.

Keywords: Fine needle aspiration; Leiomyosarcoma; Low-grade endometrial stromal sarcoma; Neuroendocrine tumor; Solitary fibrous tumor; Synovial sarcoma.

Publication types

  • Case Reports

MeSH terms

  • Biopsy, Fine-Needle / methods
  • Diagnosis, Differential
  • Endometrial Neoplasms / diagnosis
  • Endometrial Neoplasms / pathology
  • Endometrial Stromal Tumors / diagnosis
  • Endometrial Stromal Tumors / pathology*
  • Female
  • Humans
  • Middle Aged
  • Multiple Pulmonary Nodules / diagnosis
  • Multiple Pulmonary Nodules / pathology*
  • Neoplasm Grading / methods
  • Sarcoma, Endometrial Stromal / diagnosis
  • Sarcoma, Endometrial Stromal / pathology*
  • Sarcoma, Synovial / diagnosis
  • Sarcoma, Synovial / pathology*
  • Smooth Muscle Tumor / diagnosis
  • Smooth Muscle Tumor / pathology