[Usefulness of ultrasonography-guided fine needle aspiration cytology in a case of jejunal leiomyosarcoma]

Abstract

The patient was a 45-year-old man with the symptoms of abdominal pain and constipation. Laboratory data showed no remarkable changes. Ultrasonic and CT-scan examinations revealed a mass deeply situated in the abdominal cavity. Ultrasonography guided needle aspiration cytology was performed. Obtained specimen showed a large cluster accompanied by numerous smaller clusters, and dispersed single cells. Most of cells were spindle in shape with abundant cytoplasm, and uniform in size. These cells have moderately hyperchromatic nuclei with finely granular pattern, which were round or oval, and have tiny nucleoli. Some cells were binucleated. The nuclear membrane was sharp and well preserved. Giant cells or mitotic figures were not observed. As a result, cytological diagnosis was "suspicious of leiomyosarcoma". The tumor was resected. The specimen consisted of a segment of the jejunum with an irregularly-shaped, and reddish soft first-sized mass continued to jejunum muscle layer. The cut surface of the mass showed central cavitation and necrosis in part. Histological diagnosis was well differentiated leiomyosarcoma originated from the jejunum. The tumor was composed of smooth muscle like cells arranged in bundles with some bizarre multinucleated cells and rare mitotic figures.