Neuroblastoma with concomitant giardiasis - Report of a case with diagnosis by fine needle aspiration cytology

BACKGROUND: Diagnosis of two pathologies, including a neoplasm and infectio us condition, by fine needle aspiration (FNA) cytology hi the same patient is rare. CASE: A 2-year-old, male child presented with fever, abdominal pain and abd ominal mass. Imaging findings were strongly hi favor of a neuroblastoma. IN A smears from the mass revealed fecal material containing numerous trophozo ites of Giardia lamblia. FNA was repeated in view of the imaging findings. Repeat smears showed a small round cell tumor with rosettes and background filamentous/fibrillar material consistent with a;neuroblastoma. Chemotherap y reduced the mass considerably. Histopathology of the resected residual ma ss revealed a ganglioneuroma in addition to remnants of neuroblastoma. The patient was free of disease two years after the initiation of chemotherapy. CONCLUSION: When FNA cytology shows an infectious pathology hi the clinical mid imaging setting of a tumor, FNA should be repeated so that an importan t component of the diagnosis is not missed.