Cytologic features of ovarian granulosa cell tumor metastatic to the lung - A case report

BACKGROUND: Granulosa cell tumor (GCT) of the ovary is an uncommon but not rave tumor, and the adult type usually affects postmenopausal women. The ad ult type of GCT has several characteristic clinicopathologic features, incl uding a composition of small, uniform cells with Call-Exner bodies and an a bility to metastasize to extrapelvic organs, even several decades after the initial operation. CASE: A 62-year-old female was incidentally found to have multiple shadows in the peripheral portions of both lung fields on roentgenography. She had a past history of oophorectomy for an ovarian carcinoma more than 20 years earlier. A transbronchial lung biopsy series tons nondiagnostic. An aspirat e obtained by transthoracic fine needle aspiration (FNA) biopsy revealed cl usters of rather uniform, small cells with nuclear grooves, suggestive of a metastatic lung tumor. Histologic examination of the lung tissue in compar ison with the previous oophorectomy specimen confirmed the impression of GC T metastatic to the lung. CONCLUSION: A preoperative diagnosis of metastatic lung tumor was establish ed by transthoracic FNA cytology. The important cytologic criteria for the differential diagnosis are uniformity of tumor cells, coffee bean-like nucl ear grooves and Call-Exner bodies. The possibility of late recurrence of th is kind of tumor, even two or three decades after surgical resection, shoul d be kept in mind.