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Metastasis of unknown origin: The role of fine‐needle aspiration cytology
Author(s) -
Reyes Cesar V.,
Thompson Karen Sue,
Jensen JoAnne D.,
Choudhury Abdul M.
Publication year - 1998
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/(sici)1097-0339(199805)18:5<319::aid-dc1>3.0.co;2-5
Subject(s) - medicine , pathology , papanicolaou stain , lung , metastasis , fine needle aspiration , adenocarcinoma , pagetoid , cervical lymphadenopathy , prostate , lymph , cytology , biopsy , immunohistochemistry , cancer , disease , cervical cancer
Metastasis of unknown origin (MUO) manifests either as a tumor deposit in an organ, often cervical lymphadenopathy, or as a multiorgan carcinomatosis. As a diagnostic and therapeutic challenge, the definition of its cell type and possibly its origin is imperative, although a limited diagnostic investigation is usually recommended. At Hines VA Hospital, from 1986 to 1994, there were 116 cases with admitting clinical diagnosis of MUO, evaluated by fine‐needle aspiration cytology (FNAC). The ages of patients ranged from 29 to 82 years (mean 56 years). All were male; Caucasians predominated. The FNAC examination with Diff‐Quik and Papanicolaou smears were complemented with special and immunostains in 48 cases (41%) and electron microscopy in 93 cases (80%). The FNAC involved lymph nodes in 57 cases (49%), liver in 27 cases (23%), skin in 22 cases (19%), bone in six cases (5%), lung in three cases (3%), and pleura in one case (1%). The neoplasm was generally cell typed, and there were 60 adenocarcinomas/poorly differentiated carcinomas, 26 small‐cell carcinomas (SCC), 23 squamous‐cell carcinomas (SQCC), and six undifferentiated large‐cell carcinomas. The primary source was defined in 30 cases (26%), consisting of lung in 11 cases, prostate in nine, kidney in four, colon in four, pleura in one, and peritoneum in one. Clinical correlation also supported a lung origin for the SCC, while the majority of the SQCC in upper and middle cervical lymph nodes were considered head‐and‐neck tumors. Our results affirm that FNAC is a viable and simple procedure in MUO investigations. Diagn. Cytopathol. 1998;18:319–322. © 1998 Wiley‐Liss, Inc.