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Clinical History

A 29-year old female with incidentally discovered left retroperitoneal mass during workup for nausea and vomiting. A non-contrast CT scan shows a 5.1 cm left retroperitoneal mass at the level of the mid and lower pole of the left kidney. A CT-guided fine needle aspiration and core biopsy of the mass were performed and sent for cytopathological evaluation.

Cytopathology Features

Fine needle aspiration biopsy of ganglioneuroma usually will reveal scant fragments of tissue consisting of loose fibrillary matrix embedded with spindle-shaped Schwann cells demonstrating wavy, uniform, elongated nuclei with fine chromatin and delicate ill-defined cytoplasm. Scattered mature ganglion cells with abundant granular, well-defined, eosinophilic cytoplasm, large nuclei with vesicular chromatin; and prominent nucleoli are also identified. Mitotic figures, necrosis, and atypia are not usually observed.

Figure 2: Diff-Quik stain, 40X
Figure 1: Diff-Quik, 40X
Figure 3: Cell Block, 40X

Saeed Asiry, MBBS
Vira Wolf, MD, MS, SCT(ASCP),
Lenox Hill Hospital, New York, NY