BRONCHIOLOALVEOLAR CARCINOMA IN PROGRESSIVE SYSTEMIC-SCLEROSIS - REPORT OF A CASE DIAGNOSED BY FINE-NEEDLE ASPIRATION CYTOLOGY

BACKGROUND: Progressive systemic sclerosis (PSS) is a systemic disorde r involving many internal organs, including the lungs. The occurrence of a pulmonary tumor has occasionally been reported, especially in lon g standing cases. Bronchioloalveolar carcinoma is the most prevalent h istologic type. CASE: A 35-year-old male with a 12-year history of PSS presented with exertional dyspnea and pain in the left side of the ch est. Fine needle aspiration cytology (FNAC) showed abundant cellular m aterial with large, monolayered sheets and papillary structures. The n eoplastic cells had uniform round to oval nuclei and spacious cytoplas m. Some had intranuclear vacuoles. Phosphotungstic acid-hematoxylin (P TAH) stain revealed structures in the form of prominent cell membranes rimming the free surfaces of the tumor cells. The overall cytologic p icture was interpreted as consistent with bronchioloalveolar carcinoma . The patient's condition did not permit surgery. CONCLUSION: In this case the development of bronchioloalveolar carcinoma occurred over a 1 2-year period following the diagnosis of PSS. This case emphasizes dia gnosis of the tumor solely by FNAC. PTAH stain was also helpful in the cytologic diagnosis.