Metastatic myxoid liposarcoma of lung and mediastinum diagnosed by fine needle aspiration

Myxoid liposarcomas metastatic to lungs and mediastinum are infrequent lung neoplasms. The tumor has an aggressive course and needs to be recognized cytologically. A 60-year-old male smoker presented with gradually progressive left-sided chest pain, cough, and expectoration for the past one month. Chest radiograph and computed tomography of thorax revealed a lung mass in left apical region extending into the posterior mediastinum, which was subjected to ultrasound-guided fine needle aspiration (FNA). Smears showed a cellular tumor with ovoid to spindle shaped tumor cells in a myxoid background having a rich vascular network. The possibility of a myxoid liposarcoma metastatic to lung and mediastinum was suggested and confirmed by histopathology. A previous history of excision of a tumor in the thigh one and half years ago was present. The importance of recognizing the cytological picture by FNA is discussed.