Large retroperitoneal soft tissue tumor: A cytopathological diagnosis

Abstract

(CECT) abdomen revealed a large retroperitoneal mass lesion of size 31 cm × 22 cm × 20 cm with areas of fat density within and showed heterogeneous postcontrast enhancement causing displacement of right kidney, pancreas, and bowel loops, most likely suggestive of liposarcoma [Figure 1]a.{Figure 1} Fine-needle aspiration cytology. Explanation Smears examined showed high cellularity comprising highly pleomorphic malignant cells arranged in large sheets embedded in myxoid matrix, loosely cohesive clusters, and groups as well as many singly dispersed [Figure 1]b. The cells were round to oval and spindle-shaped with high nuclear-cytoplasmic ratio, marked anisonucleosis, irregular nuclear membrane, coarse granular chromatin, prominent nucleoli, and scant to moderate amount of pale foamy cytoplasm [Figure 1]c. Few binucleated, multinucleated bizarre tumor cells and mitosis were also noted [Figure 1]c. Many scattered atypical/pleomorphic lipoblasts were also seen having multilobated, hyperchromatic, and indented nuclei with multiple vacuoles in the cytoplasm [Figure 1]d. Few inflammatory cells and myxoid matrix were also seen in the background. In a review by Fletcher et al.,[6] it was concluded that adequate histopathological gross sampling is essential to show the presence of lipoblastic differentiation and even a focal collection of pleomorphic lipoblasts can help in labeling the tumor as PLS.