Wazir J F.
Lingual alveolar soft part sarcoma (ASPS): A case report and literature review.
Int J Pathol Jan ;3(1):37-9.

Eighteen years old Iraqi presented with two years history of a slowly growing lingual tumour, which eventually extended into the right side of the neck. Specimen received included tongue, right mandible, submandibular gland, external jagular vein, skeletal muscle and cervical lymph nodes. There was a fleshy greyish tumour measuring 8 X 7 cm, arising in the dorsum of the tongue and has infiltrated the neck muscle, submandibular gland, external jagular vein and surrounded the mandible on its medial aspect. All the resection margins were clear by at least 2 cm. Multiple blocks were submitted for histological examination including five blocks from the tumour. The tumour revealed partly alveolar and partly solid and organoid growth patterns, comprising nests of large malignant cells. The nests of tumour cells were surrounded by delicate fibrovascular septa, containing occasional thin walled vascular channels. The tumour cells were polygonal and rounded having vesicular nuclei with prominent nucleoli, and abundant eosinophilic granular cytoplasm. Some of the tumour cells had vacuolated cytoplasm. Mild nuclear pleomorphism was noted. Mitotic activity was noticeable (four mitoses per 10 HPF). Intracytoplasmic crystalline material was identified using PAS stain with prior diastase treatment. There was extensive vascular invasion including external jagular vein. Immunohistochemistry showed positive cytoplasmic granular staining pattern of the tumour cells for Myo D1 and NSE and focal cytoplasmic positivity for Desmine. The tumour cells were negative for alpha Smooth Muscle Actin, pan-cytokeratin marker MNF116, S-100 protein, HMB-45 and chromogranin. Electron microscopy was not performed.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com