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CytoJournal 2016,  13:4

Fine needle aspiration biopsy of metastatic malignant mesothelioma with myxoid change and signet ring cells: A case report and review of the literature

1 Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
2 Department of Pathology, Cleveland Clinic, Cleveland, OH 44195, USA

Correspondence Address:
Deborah J Chute
Department of Pathology, Cleveland Clinic, Cleveland, OH 44195
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1742-6413.177157

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Malignant mesothelioma (MM) is a rare neoplasm, which is most commonly encountered in cytology through effusion specimens. Fine needle aspiration biopsy of MM, particularly the epithelioid subtype, can be a source of diagnostic difficulty and may mimic sampling of an adenocarcinoma. This is the first case report to demonstrate abundant extracellular myxoid material and numerous intracellular vacuoles, including signet ring cells, in a fine needle aspirate of metastatic MM. A review of the literature for myxoid change and vacuoles in fine needle aspiration biopsies of MM discloses that vacuoles are found in up to 35% of aspirates of MM, but myxoid change is very rare, reported in <5% of the cases. Cytologists should be aware of this rare morphologic pattern of metastatic epithelioid MM.


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