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- Domanski, Henryk, et al.
(författare)
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Low-grade fibromyxoid sarcoma is difficult to diagnose by fine needle aspiration cytology: a cytomorphological study of eight cases.
- 2009
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Ingår i: Cytopathology. - : Wiley. - 1365-2303 .- 0956-5507. ; 20, s. 304-314
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low-grade fibromyxoid sarcoma (LGFMS) is an uncommon neoplasm with bland morphology and an indolent clinical course, although metastases may develop in approximately 5-10% of the cases. The diagnosis of LGFMS can be difficult to render from fine needle aspiration cytology (FNAC) alone because of morphological overlap with other spindle cell and myxoid lesions. Objective: To determine cytological criteria for LGFMS by reviewing FNAC aspirates in eight cases and to compare the findings with those in subsequent histological sections. Methods: FNAC slides were reviewed from eight patients with subsequently excised tumours diagnosed as LGFMS. Of these patients, six also had core needle biopsies (CNB). Cytogenetic and/or molecular analysis was carried on all tumours. Results: The patients were six men and two women ranging in age from 26 to 78 years. Tumours arose in the deep soft tissues of the thigh (n = 5), shoulder girdle (n = 1) or upper arm (n = 1) and one in the subcutaneous tissue of the abdominal wall. Cytological features included clusters of bland spindle and round/polygonal cells embedded in a collagenous and myxoid matrix along with dissociated, uniform or slightly/moderately pleomorphic spindle cells, bare nuclei and fragments of collagen and myxoid tissue in varying proportions. Unequivocal sarcoma was diagnosed in two aspirates, but mitoses were absent in all cases. In three cases, the diagnosis was inconclusive with regard to benignity or malignancy, while three were erroneously diagnosed as benign spindle cell lesions. Although the diagnosis was suggested on three of six CNB, these presented similar diagnostic problems. Conclusions: There were no cytomorphological findings in FNAC to allow for a clear cut separation of LGFMS from other spindle cell or myxoid lesions, but high-grade sarcoma could be excluded. Surgical (incisional or excisional) biopsy or, alternatively, examination of RT-PCR for the FUS/CREB3L or FUS/CREB3L1 fusion transcripts may be necessary to obtain a correct diagnosis.
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| 2. |
- Åkerman, Måns, et al.
(författare)
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The complex cytological features of synovial sarcoma in fine needle aspirates, an analysis of four illustrative cases
- 2007
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Ingår i: Cytopathology. - : Wiley. - 1365-2303 .- 0956-5507. ; 18:4, s. 234-240
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The cytological features of conventional monophasic spindle cell and biphasic synovial sarcoma have been defined in detail in several large series. The cytology of rare morphological variants, especially the subtypes of poorly differentiated synovial sarcoma, are insufficiently evaluated and diagnostically difficult to define. The objective of the present study was to call attention to the variable cytology of rare variants of synovial sarcoma. Furthermore, adjunctive diagnostic methods, necessary for a correct diagnosis, are discussed. Methods: Aspirates from four synovial sarcomas, with cytological features, which differed from those of conventional synovial sarcoma and from each other, were retrieved from our files and re-evaluated. Results: In three of the cases a correct diagnosis was not obtained from routinely stained aspirates. In the fourth case, the correct diagnosis was established by a combination of cytomorphology, immunocytochemistry and fluorescence in situ hybridization (FISH) performed on the aspirated material. Conclusion: Ancillary diagnostic methods are necessary in the examination of aspiration smears from synovial sarcoma, especially of morphological variants with a cytomorphology that differs from conventional spindle-cell monophasic and biphasic tumours. Immunocytochemistry and molecular genetic examinations (reverse transcriptase polymerase chain reaction or FISH) are the methods of choice.
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