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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2018.07.16    [Epub ahead of print]
Abrupt Dyskeratotic and Squamoid Cells in Poorly Differentiated Carcinoma: Case Study of Two Thoracic NUT Midline Carcinomas with Cytohistologic Correlation
Taebum Lee1, Sangjoon Choi1, Joungho Han1, Yoon-La Choi1, Kyungjong Lee2
1Department of Pathology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Corresponding Author: Joungho Han ,Tel: 82-2-3410-2800, Fax: 82-2-3410-0025, Email: hanjho@skku.edu
Received: May 30, 2018;  Revised: July 10, 2018  Accepted: July 14, 2018.  Published online: July 27, 2018.
ABSTRACT
Cytologic diagnosis of nuclear protein in testis (NUT) midline carcinoma (NMC) is important due to its aggressive behavior and miserable prognosis. Early diagnosis of NMC can facilitate proper management, and here we report two rare cases of thoracic NMC with cytohistologic correlation. In aspiration cytology, the tumor presented with mixed cohesive clusters and dispersed single cells with diffuse background necrosis and many neutrophils. Most of the tumor cells had scanty cytoplasm and medium-sized irregular nuclei, which had fine to granular nuclear chromatin. Interestingly, a few dyskeratotic cells or squamoid cell clusters were present in each case. Biopsy specimen histology revealed more frequent squamous differentiation, and additional immunohistochemistry tests showed nuclear expression of NUT. Because this tumor has a notorious progression and has been previously underestimated in terms of its prevalence, awareness of its characteristic findings, proper ancillary tests should be considered in all suspicious cases.
Key Words: BRD4-NUT fusion oncogene protein; NUT midline carcinoma; lung; cytology
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