Cardiac tamponade as an initial presentation of papillary carcinoma with psammoma bodies and intranuclear grooves-A diagnostic dilemma

Diagn Cytopathol. 2019 Sep;47(9):927-929. doi: 10.1002/dc.24215. Epub 2019 May 23.

Abstract

Involvement of body fluids by adenocarcinoma is a common phenomenon. However, metastasis to the pericardial fluid by adenocarcinoma is a rare occurrence. The most common malignancies associated with malignant pericardial effusion are carcinoma of the lung, breast, esophagus, melanoma, lymphoma, and leukemia. Here, we discuss a case of a 36-year-old female with hemorrhagic pericardial effusion presenting with cardiac tamponade and psammoma bodies which was suspected and reported as metastatic papillary carcinoma of thyroid on cytomorphology; however, the immunocytochemical and radiological features confirmed metastatic papillary adenocarcinoma of lung contrary to the thyroid which is more common and expected.

Keywords: Psammoma bodies; cytopathology; papillary carcinoma lung; pericardial effusion.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cardiac Tamponade* / metabolism
  • Cardiac Tamponade* / pathology
  • Female
  • Heart Neoplasms* / metabolism
  • Heart Neoplasms* / pathology
  • Heart Neoplasms* / secondary
  • Humans
  • Neoplasm Metastasis
  • Pericardial Effusion* / metabolism
  • Pericardial Effusion* / pathology
  • Thyroid Cancer, Papillary* / metabolism
  • Thyroid Cancer, Papillary* / pathology
  • Thyroid Neoplasms* / metabolism
  • Thyroid Neoplasms* / pathology