Hepatic Undifferentiated (Embryonal) Sarcoma: A Case Report with Fine Needle Aspiration Cytology and Histology

Hepatic undifferentiated (embryonal) sarcoma is an unusual malignant liver tumor with an overwhelming predilection for children. Fine needle aspiration (FNA) cytology of these tumors rarely has been described in the literature. In this report, we described the clinical, radiologic, cytomorphologic, histopathologic, immunohistochemical, and DNA ploidy features of a similar tumor in an 18 year-old patient. The FNA smears showed clusters and isolated tumor cells with marked variation in morphology including spindle cells, large bizarre anaplastic cells, and giant tumor cells. The histopathologic sections recapitulated the varied morphologic patterns within the tumor cells and also showed characteristic eosinophilic intra- and extracytoplasmic globules. DNA ploidy studies, by image analysis, demonstrated this tumor as an aneuploid tumor, indicating poor prognosis. FNA cytology can be utilized as a sensitive screening tool for these rare tumors.