Which histologic findings are characteristic of pleural desmoplastic small round cell tumor (DSRCT)?

Updated: Dec 25, 2019
  • Author: Joseph F Tomashefski, Jr, MD; more...
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Answer

DSRCTs of the pleura have the same histology as tumors occurring in the abdominal/pelvic cavity. They typically consist of demarcated nests of small round cells surrounded by a dense fibrous or cellular spindle cell stroma. Nuclei are hyperchromatic with inconspicuous nucleoli and multiple mitoses (>3 per 10 high power microscopic fields). The cytoplasm contains punctate structures that correspond ultrastructurally to whorls of intermediate filaments. A minority of cases of DSRCT lack dense fibrous stroma or express unusual histological patterns such as papillary, adenoid cystic–like, signet ring cell, or spindle cell. [67, 68, 69]

Pathology of nonmesothelial cancers of the pleura. Pathology of nonmesothelial cancers of the pleura. Desmoplastic small round cell tumor. Islands of small blue cells are separated by bands of fibrous tissue.
Pathology of nonmesothelial cancers of the pleura. Pathology of nonmesothelial cancers of the pleura. Malignant small cells with a high nuclear-to-cytoplasmic ratio.

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