SYNCYTIAL VARIANT OF NODULAR SCLEROSING HODGKINS-DISEASE - FINE-NEEDLE ASPIRATION FINDINGS IN 2 CASES

The syncytial variant is a recently described, uncommon form of nodula r sclerosing Hodgkin's disease that was previously termed ''sarcomatoi d.'' In addition to foci of typical sclerosis, it is characterized his tologically by sheets or clusters of mononuclear Reed-Sternberg varian ts. These may be arranged around areas of necrosis with variable numbe rs of neutrophils. In excised material, differential diagnostic consid erations include non-Hodgkin's malignant lymphoma, granulocytic sarcom a, malignant melanoma, metastatic carcinoma, thymoma, and metastatic g erm cell tumor. We describe the fine-needle aspiration cytologic findi ng in two examples of this entity. Cohesive clusters and sheets of mal ignant cells with clear cytoplasm, vesicular nuclei, and prominent nuc leoli are easily mistaken for metastatic carcinoma or germ cell tumor. Ancillary tests useful in this differential diagnosis are discussed. (C) 1997 Wiley-Liss, Inc.