CASE N°11 – Abdominal Paraganglioma

Clinical History:

Age: 47

Sex:  Male

Asymptomatic. In center back peritoneum a solid para-aortic mass of approximately 6x4x5 cm was detected during TAC-SCAN. The lesion seems to be distinguished  from the surrounding structures. Surgical removal was suggested.

Cytological Images:

Cytological material: EUS-FNA

 PAP 40X

 PAP 100X

 PAP200X

 PAP200X

Cytological Report:

Loose clusters and sometimes isolated neoplastic cells are present (histology is necessary to distinguish between benign and malignant process).

Histological Images:

Histological material: mass excision

 H/E 40X

 H/E 100X

 IIC – cromogranina+

 IIC – S-100 coherent

 IIC – Synaptofisin+

Histological Report:

Paraganglioma. Immunohistochemistry coherent.

Discussion:

Paraganglioma is a rare neuroendocrine neoplasm that may develop at various body sites. About 85% of paragangliomas develop in the abdomen; only 12% develop in the chest and 3% in the head and neck region. Mostly (97%) are benign.

Paragangliomas are categorised as originating from a neural cell line (chromaffin cells in paraganglia or chromaffin-negative glomus cells derived from the embryonic neural crest).

Most paragangliomas are asymptomatic and present medium-big size mass. Because of  size, localization and vascularization, an aortography with embolization of the nutrient branches of the tumor  is suggested before surgical  resection.

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