We present a case of dedifferentiated chondrosarcoma of the larynx in which
the dedifferentiated component was initially diagnosed by fine-needle aspi
ration (FNA). The patient was a 74-yr-old man who presented with difficulty
breathing and an anterior neck mass. A CT scan demonstrated a 4.5-cm carti
laginous lesion involving the left thyroid cartilage, with an anterior soft
-tissue component. Nine years prior, the patient had an incomplete resectio
n of a low-grade chondrosarcoma at the same site. FNA was performed on the
current lesion, demonstrating a high-grade spindle-cell sarcoma with a stor
iform pattern. The cytomorphology together with immunocytochemistry and ele
ctron microscopy were diagnostic of malignant fibrous histiocytoma (MFH), a
nd synthesis of the clinical, radiographic, and cytomorphologic features re
sulted in a diagnosis of dedifferentiated chondrosarcoma. The cytologic dia
gnosis was histologically confirmed by laryngectomy. Although rare. dediffe
rentiated chondrosarcoma should be included in the differential diagnosis o
f high-grade sarcomas of bone and cartilage assessed by FNA. Diagn. Cytopat
hol. 2000, 22:288-292. (C) 2000 Wiley-Liss. Inc.