PLEURAL EFFUSION CYTOLOGY OF EMBRYONAL RHABDOMYOSARCOMA

This case report concerns an embryonal rhabdomyosarcoma of the testis lit a 31-yr-old white male patient who underwent radical left orchiect omy, followed by combined irradiation and chemotherapy and who 2 yr la ter presented with dyspnea at rest, nonproductive cough, and lower bac k pain for 1 wk. Chest radiographs demonstrated a bilateral pleural ef fusion and diffuse infiltrating lesion of the pleurae, mimicking a mes othelioma. The pleural fluid displayed noncohesive, malignant, small, round cells about 2-5 times larger than mature lymphocyes. They had la rge, darkly staining, pleomorphic nuclei and bubbly cytoplasm with poo rly defined borders. The diagnosis of embryonal rhabdomyosarcoma was s upported by a positive myosin immunostaining and ultrastructural findi ngs of intracytoplasmic actin and myosin-type microfilaments. Our case is also notable in that the tumor. was a pure rhabdomyosarcoma involv ing a testicular origin, and the patient is the oldest reported in the literature. (C) 1997 Wiley-Liss, Inc.