case_images: PMC5203870_01
case_images: Contrast-enhanced CT scan of the neck. A well circumscribed, focally enhancing mass is noted in the left pyriform sinus (arrow).
case_images: CRIPA2016-7289017.001.jpg
case_images: PMC5203870_01_CRIPA2016-7289017.001.jpg
case_images: fig1
case_images: It was well-defined, hypodense, mostly homogenous, and nonenhancing, with a very focal area of contrast enhancement (Figure 1).
case_images: Gross appearance of the specimen.
case_images: CRIPA2016-7289017.002.jpg
case_images: PMC5203870_01_CRIPA2016-7289017.002.jpg
case_images: fig2
case_images: Gross examination revealed multiple pieces of soft yellow-tan and glistening tissue measuring 7.5 x 6.5 x 0.5 cm in aggregate (Figure 2).
case_images: (A) Hematoxylin and eosin- (H&E-) stained sections showed a hypocellular neoplasm with myxoid background, ropy collagen bundles, and plexiform blood vessels (100x). (B) Mature adipocytes with scattered bland spindle cells (400x).
case_images: CRIPA2016-7289017.003.jpg
case_images: PMC5203870_01_CRIPA2016-7289017.003.jpg
case_images: fig3
case_images: On microscopic examination, the pieces are composed of a hypocellular spindle cell neoplasm with abundant myxoid background and plexiform blood vessels (Figure 3(A)). Few mature adipocytes are present as single cells or as small clusters scattered throughout the lesion (Figure 3(B)).
case_images: (A) H&E-stained section showed the dendritic cytoplasmic processes of the spindle cells (arrow) (600x). (B) Immunohistochemistry for CD34 also highlights the dendritic cytoplasmic processes.
case_images: CRIPA2016-7289017.004.jpg
case_images: PMC5203870_01_CRIPA2016-7289017.004.jpg
case_images: fig4
case_images: The spindle cells have a stellate shape with small oval nuclei, inconspicuous nucleoli, and multiple dendritic cytoplasmic processes (Figure 4(A)). The dendritic cytoplasmic processes were highlighted by CD34 (Figure 4(B)) and vimentin.