Cytology of pleuropulmonary blastoma: A case report

This case report describes the cytological features of pleuropulmonary blastoma (PPB), a rare aggressive paediatric tumour. The patient was a 13 year old male and he presented with recurrent lower respiratory tract infections and failure to grow. The smears which were prepared from the CT guided aspirates showed groups and clumps of two populations of cells. The predominant population consisted of large spindle shaped cells with round to oval nuclei, eosinophilic cytoplasm and irregular nuclear membranes. The nuclei possessed fine granular chromatin and inconspicuous nucleoli. The second population of cells was less abundant, interspersed amidst the spindle shaped cells and it consisted of small round cells with scanty eosinophilic cytoplasm. The nuclei possessed fine granular chromatin and inconspicuous nucleoli. Occasional mitoses were observed. There was no evidence of rosette or gland formation. The main differential diagnosis was PPB. The other differential diagnoses were teratoma, neuroblastoma, metastatic Wilm’s tumour, rhabdomyosarcoma and malignant mesenchymoma. Histopathology confirmed the diagnosis of PPB. The age of presentation in the present case report was more than the reported median age of presentation. This tumour may be easily misdiagnosed due to the rarity of its occurrence. The cytological appearances may vary according to the various cell populations which are present.