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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-
atric Surgical Case Report 27 . 2017; 7-11.
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