Sohsuke Yamada, Atsunori Nabeshima, Hirotsugu Noguchi, Aya Nawata, Hidetaka Uramoto and Toshiyuki Nakayama
A history of recent frequency in cough and sputum was presented in a 73-year-old male. A neck CT scan revealed a heterogeneously enhanced and poorly-demarcated mass, measuring approximately 35 × 35 mm, arising from the right cricoid cartilage and projecting into the airway. The inadequate cytologic specimen contained few individual cells or small clusters of tumor cells having pleomorphic and sometimes spindle- or multi-nuclei, and abundant clear or vacuolated cytoplasm, along with an amount of metachromatic chondroid stroma. We first interpreted it merely as carcinoma. A total laryngectomy was performed, and gross examination showed a multilobulated and firm mass with a grayish to whitish, fleshy and glistening appearance, involving the cricoid cartilage and cricothyroid muscle. However, the overlying surface tracheal mucosa was smooth. Microscopically, the tumor was predominantly composed of a solid proliferation of atypical chondrocyte-like cells having hyperchromatic bi- or multi-nuclei in a lobular fashion, embedded in an abundant chondroid matrix, associated with cellular spindled cell foci. Therefore, we finally made a diagnosis of grade 2 chondrosarcoma with spindle cell components. We should be aware that owing to its characteristic features, cytopathologists might be able to determine correct diagnosis, based on multiple and adequate cytology samplings.
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