Case 1115 - A Male Patient in His 60s with Flank Pain and Early Satiety

Cytopathology

Case Prepared By: Mason Marshall, D.O. and Samer Khader, M.D.

Case Presentation: 

A male patient in his sixties presented with flank pain and early satiety. A recent colonoscopy (only up to the hepatic flexure) was unremarkable. A CT scan revealed a large partially cystic 14 x 13 cm retroperitoneal mass. An ultrasound-guided fine needle aspiration and core needle biopsy were performed on the mass.

Biopsy Results:

Figure 1
Figure 1 - Cell block material, H&E (20X).
Figure 2
Figure 2 - Core needle biopsy, H&E (20X).

 Immunohistochemistry:

The tumor cells are positive for PAN-CK, CK20, CK7, SATB2, CDX2 in the glandular component, while positive for GATA3 and patchy positive for SALL-4 in the solid component. Chromogranin, synaptophysin, CD56, PSA, PAX-8, p40, calretinin, and WT1 are all negative.

The specimen was also sent for FISH studies:

Figure 3
Figure 3: FISH Results

Probe:  LSI 12ptel/CEP12 Cytogenetic location: 12 p telomere/12p11.1q11.1

# Cells Analyzed: 48

Ratio 12ptel/CEP12: 1.86

Diagnosis and Discussion