Cayuga Medical Center report on aspiration biopsy
20 August 2004

Diagnosis:
	Myxoid and epithelioid neoplasm (pending outside
consultation with Dr. J. Brooks, Univ. of Pennsylvania)

Comment:
	The cytolic smears are cellular.  They demonstrate
eosinophilic and epithelioid  cells.  Moderate nuclear variability.
Extreme pleomorphism infrequent. Mucoid background material present.
Cell block preps shows eosinophilic epithelioidal cells, but
also demonstrate prominent extra-cellular myxoid matrix, which
divides the cells into small clusters and linear aggregates.  Full
cartilagneous differentiation with lacune formations not seen.
	
	Immuno. studies with broad -spectrum cytokeratin cocktail
are positive in the epithelioid cells.  S100 protein is negative.

	Differential diagnosis includes a variety of mixoid-rich
neoplasms such as (para)chordoma variants, (chondro)sarcoma, and
epithelial malignancy.