Lymphangioleiomyomatosis. Is fine needle aspiration cytodiagnosis possible?

Lymphangioleiomyomatosis is a rare condition characterized by a proliferation of the smooth muscle cells, mainly in the lymphatic system, giving rise to blockage of the thoracic duct with chylothorax and chyloascites. This condition was seen in a 34-year-old woman with an abdominal tumor that was subjected to fine needle aspiration. The cytologic diagnosis of this neoplasm is difficult since the cellularity and the cytologic picture indicate malignancy. The organoid configuration together with the chylus formation gave an important clue to the correct diagnosis, which, however, was not made until after a biopsy was performed and the cytologic and histologic findings were combined. The cytologic, histologic and electron microscopic findings are presented.