Diagnostic Cytopathology | 2021
Squamous cells in pericardial fluid
Abstract
Mediastinal teratomas account for <10% of all mediastinal masses. Anterior mediastinal teratomas are known to cause cardiac tamponade but rupture of mediastinal teratoma in the pericardial cavity is rare. During reporting of pericardial fluid cytology specimen, it is essential to be aware of the clinico-radiological findings of this rare entity for careful correlation to arrive at a specific diagnosis. A 23-year-old male presented with complaints of left sided chest pain, shortness of breath, dry cough and edema of feet for 3 months. On systemic examination, the patient had decreased breath sounds in the left infra-scapular region. On CT scan of the chest, a well-defined 12.9 x 7.9 x 11.1 cm sized predominantly cystic mass with areas of fat along with coarse calcifications within was seen located in the anterior mediastinum. It was abutting the arch of aorta and the main pulmonary artery without obvious infiltration. There was abutment of the left ventricle as well. Loss of fat planes with the underlying pericardium was noted. Multiple enlarged pre-vascular and lower right paratracheal nodes were noted which were indeterminate. There was mild to moderate pericardial and pleural effusion. Alphafetoprotein (AFP), Lactate dehydrogenase (LDH) and β-Human chorionic gonadotropin (β-HCG) were within normal limits. 100 mL of yellowish-white turbid pericardial fluid sample was sent to the laboratory. On microscopy, centrifuged cytology smears (both Giemsa and Papanicolaou stained) revealed few singly scattered