Good afternoon Curofians on this breezy sunday. Hope y'all enjoying your holiday. Case details : 13 year old female, diffuse mass over right paravertebral region on the back. Swelling soft and ill defined. Swelling roughly measured 6x4 cms. FNAC done, aspirated blood mixed granular white material, easy to spread. USG not affordable by the patient. Attached 12 slides. What is your cytodiagnosis? Give precise description, differential diagnosis, further workup and your suggestions. Thank you, Best regards. [Credit : Dr.Kazi Wajid Husain.,MD]

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sir might be round cell tumor

Small round cell tumor

small round cell tumor

Additional image 11.

lymphoma
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Additional image 12.

cytosmears are cellular, findings are suggestive of small round cell tumour.

monomorphic population of cells...round cell tumor

Respected sir, thank you for sharing this case Smears from a paravertebral mass is highly cellular and show branching sheets, clusters and singly scattered oval to round cells with hyperchromatic nuclei, regular uniformly dispersed chromatin exhibiting mild anisonucleosis and moderate to scant cytoplasm. Few rosettes or acini formation are noted. Occasional mitotic fig are seen. No necrosis is noted. No multinucleate cells or myxoid background or neurophil background or lymphoglandular bodies are seen. Impression : FNA from paravertebral mass showing a SMALL ROUND CELL TUMOUR. D/D: 1. Ewing/PNET 2. Alveolar RMS 3. Synovial sarcoma 4. Rare : DSRCT, Small cell Osteosarcoma, lymphoma/leukaemia, Rhabdoid tumour. Suggestions : 1. Core biopsy with IHC for Subtyping. Panel: CK, VIMENTIN, LCA, MYOGENIN, CD99, BCL2, TLE 1 2. Sir, requires radiological correlation (MRI scan to look for plane of the swelling, nature and necrosis, etc) Thank you sir. Regards...

Revered Dr. Sivaganesh sir, We are almost done.. Excellent description and interpretation, we couldn't have asked for more. Given a single option to select a diagnosis among your differentials, what would you choose based on the age, clinical site and crisp cytological details as described by you. And what is your opinion regarding the tumor cell orientation towards vessels. Thank you sir.
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cellular smears. Most of the cells are arranged in papillary , branching pattern. occasional acini are noted. cells are uniform. Hyperchromatic nuclei. mild anisonucleosis and scanty cytoplasm.. possibility of 1. synovial sarcoma 2. Alveolar RMS 3. Rule out RCC papillary form. Though it is rare in this age 4. secondary deposit from papillary carcinoma thyroid require radiological correlation

Cytosmears s/o small round cell tumour

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