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Herein, we report on a 41\u2010year\u2010old man with no significant past medical history who presented with pancytopenia and shortness of breath and was found to have widely metastatic sinonasal alveolar rhabdomyosarcoma, including involvement of the pleura. The pleural fluid specimen was cellular and contained ARMS cells in small\u2010to\u2010medium sized three\u2010dimensional fragments that resembled an adenocarcinoma or mesothelioma, and numerous single cells were seen in the background. The individual tumor cells demonstrated variable morphology; all were large, with varying degree of cytoplasm, and multinucleated cells were commonly seen in the background. The cells were negative for calretinin and claudin\u20104 and were positive for myogenin, confirming the diagnosis. Given the cytomorphologic diversity of ARMS seen in serous fluid specimens, patient history and the use of confirmatory immunostains are essential.<\/jats:p>","DOI":"10.1002\/dc.24568","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T02:43:01Z","timestamp":1598582581000},"page":"1155-1161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Alveolar rhabdomyosarcomas involving serous cavity fluid specimens exhibit diverse cytomorphologies: A case report and review of the literature"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4833-6905","authenticated-orcid":false,"given":"Robert M.","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Pathology The Johns Hopkins University School of Medicine  Baltimore Maryland 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