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Case Reports
. 2016 Apr 20:13:9.
doi: 10.4103/1742-6413.180783. eCollection 2016.

Sclerosing hemangioma: A diagnostic dilemma in fine needle aspiration cytology

Jennifer Zeng  1 , Fang Zhou  1 , Xiao-Jun Wei  1 , Sandor Kovacs  2 , Aylin Simsir  1 , Yan Shi  1
Affiliations
Case Reports

Sclerosing hemangioma: A diagnostic dilemma in fine needle aspiration cytology

Jennifer Zeng et al. Cytojournal. .

Abstract

Sclerosing hemangioma of the lung is a benign neoplasm with a widely debated histogenesis. It has a polymorphic histomorphology characterized by a biphasic cell population of "surface cells" and "round cells" arranged in four general patterns: Papillary, solid, angiomatous, and sclerotic. This variability in histomorphology makes it difficult to diagnose sclerosing hemangioma by fine needle aspiration (FNA). We present a case of sclerosing hemangioma diagnosed on FNA with immunohistochemistry performed on an accompanied cell block. The clinical presentation, cytomorphology, immunohistochemistry, and differential diagnoses are discussed.

Keywords: Cytology; fine needle aspiration; lung; pneumocytoma; sclerosing hemangioma.

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Figures

Figure 1
Figure 1
Noncontrast computed tomography scan of the chest showing a 2 cm round soft tissue mass with smooth regular margin in the left lower lobe
Figure 2
Figure 2
Fibrotic stromal fragment with papillary features in a background of abundant blood (Papanicolaou stain, ×100)
Figure 3
Figure 3
Fibrovascular fragment associated with round cells (Diff-Quik stain, ×200)
Figure 4
Figure 4
Cohesive sheets of surface cells arranged in pavement-like fashion (Diff-Quik stain, ×400)
Figure 5
Figure 5
Dense collagenous stromal tissue associated with bland appearing round cells (×200)
Figure 6
Figure 6
The papillary front on the cell block lined by a single layer of flat surface cells is focally hyalinized. Scattered round cells and inflammatory cells are observed in the center of this structure (H and E, ×200)
Figure 7
Figure 7
Both surface and round cells are positive for thyroid transcription factor-1 immunostain (×200)
Figure 8
Figure 8
AE1/AE3 immunoreactivity is present in the surface cells but not the round cells (×200)
Figure 9
Figure 9
Progesterone receptor immunoreactivity is present in the round cells but not the surface cells (×200)
See this image and copyright information in PMC

References

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