|Year : 2015 | Volume
| Issue : 1 | Page : 42-43
Fine-needle aspiration cytology diagnosis of paraganglioma (carotid body tumor)
Kalyani Dukkipati, Odapalli Shravan Kumar
Department of Pathology, Gandhi Medical College, Secunderabad, Telangana, India
|Date of Web Publication||16-Mar-2015|
Dr. Kalyani Dukkipati
Department of Pathology, Gandhi Medical College, Secunderabad - 500 003, Telangana
Source of Support: None, Conflict of Interest: None
A case of carotid body tumor was diagnosed based on fine-needle aspiration cytology (FNAC) in 22-year-old female who presented with a mass in the right lower cervical region. Provisional diagnosis was made as metastatic deposits. However, this case was diagnosed on FNAC as carotid body tumor due to the presence of definite diagnostic features on cytology like hemorrhagic aspirate, with clusters and as well as discrete cells, which are round to oval with moderate anisokaryosis, indistinct cell outlines, stippled chromatin and fine granular cytoplasm. Focal attempted acinar formation was also seen. Based on these cytologic findings and the location of the swelling, a diagnosis of carotid body tumor was made. The diagnosis was confirmed on histopathological examination. Carotid body tumor is arising from the chief cells of the carotid body, which is situated at the bifurcation of the common carotid artery. Though the fine needle aspiration was seldom suggested for the diagnosis of carotid body tumor due to its location, there were no complications during the procedure in this case. As the role of FNAC in the diagnosis of carotid body, tumor is minimized due to the severe bleeding complications of the procedure and only few cases were reported in the literature until now. However in this case, the main diagnosis was made by FNAC without any complications.
Keywords: Carotid body tumor, fine needle aspiration cytology, paraganglioma
|How to cite this article:|
Dukkipati K, Kumar OS. Fine-needle aspiration cytology diagnosis of paraganglioma (carotid body tumor). J NTR Univ Health Sci 2015;4:42-3
| Introduction|| |
Carotid body tumors are usually diagnosed by radiological, cytological and histopathological findings in correlation, and they present clinically as °cervical mass. Fine needle aspiration cytology (FNAC) is a valuable diagnostic procedure in the diagnosis of all head and neck lesions including carotid body tumors.
| Case Report|| |
A 22-year-old female presented with a swelling in the right lower cervical region for 5 months. On examination, we found that there is a swelling in the right lowers cervical region measuring 2 cm in diameter, firm in consistency, mobile and no organomegaly. Clinically metastatic deposits were suspected. FNAC was done from cervical and stained with Hematoxylin and eosin. The analysis of detailed cytological features revealed hemorrhagic aspirate with poor to moderate cellularity. The cells are round to oval arranged loosely and also single cells with indistinct cell outlines and focal attempted acinar formation and stippled chromatin [Figure 1]. Few cells are with moderate anisokaryosis and fine granular cytoplasm [Figure 2]. The diagnosis of carotid body tumor was made on cytology and also confirmed on histopathological examination.
|Figure 1: Cells arranged in attempted acinar formation, round nuclei, stippled chromatin (H and E, ×10)|
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|Figure 2: Blood rich aspirate with cells arranged loosely indistinct cell outlines (H and E, ×100)|
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| Discussion|| |
Paraganglioma is a tumor of paraganglion cells and due to its firm adherence to the underlying tissue often leads to misinterpretion of suspicion for malignancy. These are usually benign, but may occasionally produce local and distant metastasis. The clinical presentation may vary, and the diagnosis is usually made by the radiology. Clinical diagnosis is not often made until the characteristic location of the paraganglioma is determined at surgery.
Fine-needle aspiration cytology was not a preferred diagnostic tool previously due to the reported complications like hemorrhage and damage to the carotid artery.  But with certain precautions carotid body tumor can be aspirated with minimal complications.
The analysis of detailed cytological features in this case revealed the definitive diagnostic features of carotid body tumor [Figure 1], [Figure 2], [Figure 3].
|Figure 3: Hemorrhagic aspirate with round to oval cells, indistinct cell outlines and granular cytoplasm (H and E, ×40)|
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Many studies have been reported in the literature. ,,, In these, FNAC confirmed the diagnosis of carotid body tumor in cases presented with cervical lymphadenopathy and thus played a useful role in arriving at a diagnosis of this neoplasm.
In the present case, FNAC was a successful diagnostic procedure to arrive an accurate diagnosis as there were no complications during and after procedure, and the cytology revealed the typical features of carotid body tumor, which were very diagnostic. Patients with carotid body tumor can be diagnosed and operated with low risk of morbidity and mortality.
| Conclusions|| |
The patient presented with a swelling in the cervical region with relevant cytological features with supportive radiological correlation; this case was reported as carotid body tumor in the cytology. FNAC played a useful role in arriving at a diagnosis of this rare neoplasm without any complications.
| References|| |
Sanghvi VD, Chandawarkar RY. Carotid body tumors. J Surg Oncol 1993;54:190-2.
Das DK, Gupta AK, Chowdhury V, Satsangi DK, Tyagi S, Mohan JC, et al.
Fine-needle aspiration diagnosis of carotid body tumor: Report of a case and review of experience with cytologic features in four cases. Diagn Cytopathol 1997;17:143-7.
Bhat MK, Zaroo MI, Lone GN. Surgical management of the carotid body tumors, Indian J Surg 2006;68 Suppl 3:146-9.
Gulati D, Basak U, Gambhir MS, Nijhawan VS, Bharadwaj R, Satyanarayana S, et al
. Cytology of Bahal Carotid Body Tumour - A Report of Two Cases. J Cytol 2007;23.
Rosa M, Sahoo S. Bilateral carotid body tumor: The role of fine-needle aspiration biopsy in the preoperative diagnosis. Diagn Cytopathol 2008;36:178-80.
[Figure 1], [Figure 2], [Figure 3]