FINE NEEDLE ASPIRATION CYTOLOGY OF INTRATHORACIC LIPOBLASTOMA A CASE REPORT

Etty Hary Kusumastutia, Sjahjenny Mustokowenia, Dhihintia Jiwangga Sutab, Sutrisnoa

Department of Anatomical Pathologya ; Department of Cardiovascular Thoracic Surgeryb, Medical Faculty Universitas Airlangga – Dr. Soetomo Academic General Hospital

Surabaya, Indonesia

INTRODUCTION Lipoblastoma is a rare benign soft tissue tumor

It most commonly found in first three years of life

Predilection site : trunk and extremities

Intrathoracic is uncommon site

REFERENCE Coffin C. M. Mandahl N. Lipoblastoma, in WHO classification of tumous of soft tissue and bone. 4th ed. IARC. 2013; 24-25.

Han J., Kim H., Youn J. K., Oh C., Jung S., Park K., Lee S., Kim H. 2017. Analysis of clinical features of lipoblastoma in children.

Pediatric hematology and oncology.

Hudson A. S., Lacson A. G., Dicken B. J. Benign giant mediastinal lipoblastoma. Journal of pediatric surgery case reports. 40. 2019;

38-42.

Pradhan R, Mondal S, Pal S, Sikder M, Biswas B. Computed tomography-guided fine-needle aspiration and concurrent core biopsy

in diagnosis of intrathoracic mass : An evaluation of 54 cases in a tertiary care hospital. Clinical Cancer Investigation Journal. 2018.

7 : 176-9.

Sekgololo J. M., Chauke R. F., Ramoroko P. S. Intrathoracic lipoblastoma presenting with severe respiratory distress. Journal of Pedi-

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Ziegler A. C., Karplus G., Serour F., Peer M. Huge mediastinal lipoblastoma in a nine year-old boy successfully removed surgical.

Heart, Lung and Circulation. 2015; 1-3

CASE 10-year-old boy

Cough in three months and getting more frequent

Shortness of breath intermittently

Respiratory rate 30x/minutes

Asymmetric chest with suprasternal and subcostal

retraction

Decreased vesicular sound on the right lung

CT scan showed a huge mass measured 12,5 x 11,5 cm on me-

diastinum, with fat density majority, suspected as teratoma

and thymolipoma

FNAC guided by CT scan . Left : cytology composed of lipoblast which is small, round, uniform

nuclei. Chromatin is delicate. Nucleoli are absent. Right : thin branching capillaries, lipid vacuole

and sparse myxoid matrix background.

Some pieces of tissue, total weight 500 grams

Yellowish colour with gelatinous area.

Tumour show lobulated appearance with admixture

of mature and immature adipocyte, corresponding

lipoblast.

Chest X Ray revealed opacification of

mass density on the right hemithorax

with trachea shifts to the left.

DISCUSSION Lipoblastoma is benign tumor originated from em-

bryonic white fat cells (Coffin et al, 2013).

It constitute less than 1 % of childhood neoplasm. 90

% cases present in first three years of life (Ziegler et

al, 2015).

Two-thirds are found in extremities (Hudson et al,

2019).

Rare location : retroperitoneum, thoracic wall, heart,

lung, mediastinum (Hudson et al, 2019).

The symptom depends on the site (Hudson et al,

2019).

CT scan is important in determining tumor margins,

depth of tumor extension and even the origin

(Sekgololo et al, 2017).

FNAC is one of a diagnostic tools with high sensi-

tivity (84,62%) and accuracy (85,18%) for intratho-

racic lesion (Pradhan et al, 2018).

FNAC is less invasive diagnostic tools

Recurrence rate after complete resection has been re-

ported approximately 25% (Han et al, 2017).

Ki67 is associated with cell proliferation and predict

tumour recurrency (Han et al, 2017).

CONCLUSION Intrathoracic lipoblastoma is a rare benign tumour.

FNAC as pre-operative cytology procedure is useful

to diagnose lipoblastoma, although a histopathology

examination is needed for definitive diagnosis

Ki67 expressed in less than 1 % of nuclear

staining