FINE-NEEDLE ASPIRATION CYTOLOGY FINDINGS IN A CASE OF AGGRESSIVE ANGIOMYXOMA - A CASE-REPORT AND REVIEW OF THE LITERATURE

Aggressive angiomyxomas are uncommon but distinct soft-tissue neoplasm s occurring predominantly in the pelvis and peritoneum of females, but they have occasionally been reported in association with inguinal her nias in males. Histologically, these neoplasms are characterized by a proliferation of spindle- or stellate-shaped cells widely separated by loose myoxid stroma in which is dispersed a prominent vascular compon ent. The vascular component is comprised of large, thick-walled vessel s that generally do not show an arborizing pattern. Mitotic activity h as been exceedingly low in the cases reported. Because of their occurr ence within the the groin, these lesions may undergo fine-needle aspir ation (FNA). Cytologic examination of this material will reveal hypoce llular smears containing scattered spindle cells with bipolar cytoplas mic processes, as well as bland stellate cells. The nuclei are fusifor m to oval with a bland chromatin pattern. The stromal cells lie in a b ackground of watery myxoid material. While specific diagnosis by FNA i s not possible, the recognition of this cytologic appearance should ex clude lymphoproliferative processes as well as metastatic disease from the differential diagnosis. Careful attention to cytologic detail sho uld also help exclude certain other myxoid neoplasms, especially myxoi d liposarcoma. Once the myxoid stromal nature of the proliferative is recognized, a differential diagnosis of myxoid lesions can be consider ed along with a recommendation for open biopsy to establish the defini tive diagnosis. (C) 1997 Wiley-Liss, Inc.