Cytohistological correlation, immunohistochemistry and Murine Double Minute Clone 2 amplification of pulmonary artery intimal sarcoma: A case report with review of literature

Aparna Harbhajanka, Wissam Dahoud, Claire W. Michael, Robin Elliot

Research output: Contribution to journalArticlepeer-review

Abstract

Pulmonary artery intimal sarcoma is a rare aggressive intraluminal tumor often misdiagnosed as acute or chronic pulmonary thromboembolism due to its clinical presentation and radiological findings. Thus early diagnosis is very crucial and may improve patient outcome. There is limited literature on diagnosis of pulmonary artery sarcoma by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Herein, we report a case of mass-like lesion in the PA diagnosed on cytological material obtained by EBUS-TBNA with rapid on-site evaluation (ROSE). The aspirate showed pleomorphic malignant spindled cells arranged in loosely cohesive clusters. The intraluminal origin of PAIS was supported by radiographic findings. Subsequently, the patient received preoperative chemotherapy and underwent tumor resection with reconstruction. This report describes the cytomorphologic features of this rare intravascular tumor and demonstrates how limited cytological sample obtained from EBUS-TBNA with ROSE can be triaged efficiently for ancillary studies like immunohistochemistry and MDM2 amplification, thus expediting the management.

Original languageEnglish (US)
Pages (from-to)494-497
Number of pages4
JournalDiagnostic cytopathology
Volume47
Issue number5
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • cytology
  • endobronchial ultrasound-guided transbronchial needle aspiration
  • fine-needle aspiration
  • intimal sarcoma
  • lung sarcoma
  • pulmonary artery intimal sarcoma
  • pulmonary artery sarcoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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