We report on the results of fine-needle aspiration cytology of a case of on
cocytic adrenocortical carcinoma in a 39-yr-old man. The tumor invaded the
inferior vena cava and extended rip to the right atrium. Aspirate smears we
re very cellular and showed a monomorphic population of large polyhedral ce
lls with abundant granular cytoplasm, predominantly distributed singly. Mit
otic activity was inconspicuous, and there was no necrosis. Immunohistochem
ically, the tumor cells were positive for vimentin, cytokeratin, and p53, a
nd negative for synaptophysin, chromogranin, inhibin, and S-100. Ultrastruc
turally, the cytoplasm of the tumor cells was packed with mitochondria. The
patient underwent left radical nephrectomy as well as a combined cardiopul
monary bypass, with atriotomy and resection of the tumor from the right atr
ium and inferior vena cava. Three months of postoperative follow-rip were u
neventful. Diagn. Cytopathol. 2000;22:299-303. (C) 2000 Wiley-Liss, Inc.