Journal of Cytology
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CASE REPORT
Year : 2002  |  Volume : 19  |  Issue : 2  |  Page : 103-108

Neuroblastoma with divergent immunophenotype - an FNAB based case report with review of literature


1 Additional Professor, Department of Pediatrics, P.G.I.M.E.R., Chandigarh, India
2 Ph.D Student, Department of Cytology, P.G.I.M.E.R., Chandigarh, India
3 Additional Professor, Department of Cytology, P.G.I.M.E.R., Chandigarh, India

Correspondence Address:
Raje Nijhawan
Additional Professor, Dept., of Cytology, Postgraduate Institute of Medical Education & Research, Chandigrah - 160 012
India
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Source of Support: None, Conflict of Interest: None


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A case of neuroblastoma with divergent vimentin and cytokeratin positivity in an 11 year old boy is presented. The initial radiological impression was of a left renal mass consistent with Wilms' tumor. FNA revealed a tumor with an essentially discrete population of small round cells, and a few rosette-like structures. However, the presence of rare epithelial looking cells and stromal fragments coupled with vimentin and cytokeratin positivity prompted a diagnosis of a malignant round cell tumor consistent with Wilm's tumor. The appearance of skull metastasis a few weeks later prompted a review of the diagnosis. A repeat CECT scan clearly indicated a left adrenal origin of the mass. Material from a repeat FNA was submitted for electron microscopy. The detection of neurites confirmed a neuroblastoma. The earlier vimentin and cytokeratin positivity, confirmed by flowcytometry, was taken as evidence of a divergent immunophenotype. The subject of divergent differentiation in small round-cell tumors with neural features is reviewed.


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