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(a) Benign mesenchymal lesion (nodular fasciitis) cytology: myxoid background matrix with dispersed fibroblasts (Giemsa ×100). (b) Nodular fasciitis: plump, randomly oriented spindle shaped cells surrounded by myxoid stroma with dominating fibrous component (inset, Masson Trichrome) (H&E ×200). (c) Benign mesenchymal lesion (extra-abdominal desmoid) cytology: loosely arranged fibroblast-like cells with ovoid nuclei and greyish blue cytoplasm (Giemsa ×100). (d) Extra-abdominal desmoids: cellular proliferation of bland spindle shaped cells arranged into ill-defined long fascicles along with infiltration of spindle cells (inset) between skeletal muscle and fat (H&E ×100).
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Background. Soft tissue tumors are defined as nonepithelial extraskeletal tissue of the body exclusive of the reticuloendothelial system, glia, and supporting tissue of various parenchymal organs. The absence of recognizable tissue architectural patterns in cytological preparation makes diagnosis by FNAC more difficult. Aims. To assess the utility...
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Aim: Fine needle aspiration cytology (FNAC) for cytodiagnosis of various lesions is routinely used in many centers. In bone, however, FNAC has not been widely applied because of concerns about its diagnostic accuracy. The present study aims to determine the value of FNAC in the diagnosis of bone tumors.
Methods: It was a progressive observational...
Citations
... Our findings were similar to those of Roy et al., who reported an adequacy rate [3,4] In the present study, males outnumbered females by a ratio of 3.3:1, which was in contrast to the findings of Rani et al. 8:1). [4][5][6] Majority of cases in the current study were in 4-5 th decade of life with most cases in the age group 21-50 years which was in concordance with the findings of Tailor et al. and Soni et al. [7,8] Lower limb (57.8%) was found to be the most common site for mesenchymal lesions in our study, followed by upper limb. is was similar to the findings of Kotwal et al., who also reported lower limb as the most common site for soft tissue tumours. ...
... [9] Soni et al. observed upper limb and trunk to be the most common site for benign and malignant soft tissue tumors respectively. [8] Rasool et al. had majority of their cases in head and neck. [10] In the series by Tailor et al., upper limb was found to be the commonest site. ...
... In our study, 87.8% cases were found to be benign, while malignant comprised only 12 [7][8][9]12] e performance analysis in present study were comparable to the results of Rakheja et al. who observed a sensitivity, specificity, PPV, NPV and diagnostic accuracy of 95.2%, 100%, 100%, 96.4% and 97.9% respectively. [12] Soni et al. observed an accurate characterization in 77.14% cases between the cytological and final histopathological diagnosis. ...
Objectives
Fine needle aspiration cytology (FNAC) is a minimally invasive method for sampling a heterogenous lesion. It is one of the first-line investigations in the evaluation of soft tissue tumours. However, the heterogeneity of mesenchymal lesions pose a challenge to the cytological diagnosis. The present study aims at evaluation of the cytomorphological findings of mesenchymal lesions on FNAC along with their histopathological correlation.
Material and Methods
This was a retrospective study conducted over a period of 1 year from January 2021 to January 2022. All the patients of cytologically diagnosed mesenchymal lesions on their FNA aspirates were included in the study. Cytomorphology of the May Grunwald Giemsa and Papanicolaou stained slides were examined and correlated with clinical and histopathological details wherever available.
Results
Out of the 90 patients, 69 (76.7%) were males and 21 (23.3%) were females. Maximum number of cases were in 4–5 th decade of life. The lower limb was found to be the most common site (57.8%) for the mesenchymal lesions. Majority of the cases on FNA in our study were found to be benign – 79 (87.8%), while only 11 cases were malignant (12.2%). On cytological examination, spindle cell lesions were most common followed by adipocytic lesions. Based on the cyto-histological correlation, sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy of FNAC in diagnosis of mesenchymal lesion was 78.6%, 100%, 92.5%, 100% and 94.1% respectively.
Conclusion
FNAC is a simple and minimally invasive tool that plays an important role in triaging patients with good specificity and sensitivity.
... In the present study 81.60% masses were diagnosed as benign tumours and 11.86% were diagnosed as malignant on cytology. This finding was in accordance with those of Bezabih (2001) 6 4 The present study observed that benign and malignat tumours were more common in third to fourth decades and fourth to fifth decades respectively similar to the study conducted by Soni et al 9 . ...
Introduction: FNA of musculosketal masses provides a number of advantages and disadvantages. However FNA of soft tissue and bone is not widely accepted to obtain a definitive diagnosis for tumours. This study aims to establish the diagnostic accuracy of fine needle aspiration cytology in diagnosing mesenchymal tumours with reference to the subsequent histopathology report. Material and Methods: 634 patients were studied over a period of 2 years. A comparison was made between cytological and histological findings whenever possible. On correlation the sensitivity, specificity, accuracy and positive predictive value were calculated Result: Out of 634 cases, 54.36% of benign mesenchymal and 62.5% of malignant mesenchymal tumours were seen in males. 45.63% of benign and 37.5 % of malignant mesesnchymal tumours were seen in females. Soft tissue tumours (91.95%) were found to be much more common as compared to bone tumours (8.05%). The Sensitivity, Specificity and diagnostic accuracy of FNA of malignant lesions was found to be 90%, 97.72% and 95.31% respectively. Conclusion: The present study concluded that FNA is fairly reliable for correct preoperative diagnosis and management of mesenchymal tumours.
... The benign soft tissue tumors are about ten times more common than that of malignant ones. 1 Among benign tumors, lipoma is the commonest soft tissue tumor. 2 Fine needle aspiration cytology (FNAC) is a painless, easily performed, rapid, safe, and cost effective diagnostic tool in the initial categorization of tumors. It is fairly specific and sensitive in the diagnoses of primary, recurrent, and metastatic tumors. ...
... For benign, most common site was hand (14%) and for malignant thigh (7%). which was in concordance with the study done by Soni et al. 1 A study by Roy et al. stated that there was nearly equal distribution for benign tumors with a slight predilection for the upper parts and for the malignant tumors the commonest site was lower extremity. 8 In the present study, most common benign tumor was Giant cell tumor of tendon sheath. ...
Soft tissue lesions have a wide spectrum which includes non- neoplastic, benign & malignant lesions. FNAC act as preliminary diagnostic tool providing a predictive diagnosis of a benign or malignant soft tissue neoplasm and thus helps for further intervention.
This study discusses the spectrum of FNAC of soft tissue lesions in upper and lower limbs.
All cytology smears of soft tissue lesions from both upper and lower limbs were included over a period of three years at tertiary care hospital.
The most common age group was 31 to 40 years with male to female ratio being 1.3:1. The spectrum included broadly neoplastic (65.7%) & non-neoplastic (34.3%) cases. The neoplasms were further divided as benign (42.8 %), malignant (18.6%) and suspicious for neoplasm (4.3%) whereas (34.3 %) were non-neoplastic lesions. The most common lesion was giant cell tumor (GCT) of tendon sheath. The most common site was hand (24%) followed by feet (22.5%).
FNAC of soft tissue lesions is useful for differentiating various lesions and neoplasms in extremities so as to help patients in further management.
... The authors also reported specificity of 50% for adnexal tumors.In case of benign cyst, the cyst was filled of fluid, This picture gives a confidence in diagnosis as a benign lesion. In cases of lipoma and fibrolipoma, the smear showed fat globules and/or mature fat cells, fibrous elements a picture found by other authors [13]. These features give a confidence of benign lesion, but the specific diagnosis cannot be achieved. ...
Background: Evaluation of patients with cutaneous or subcutaneous nodules, especially if they are multiple, is a diagnostic challenge. This study aimed to investigate smears and cell blocks and compare them with examination of tissue biopsies. Methods: Fine needle aspiration cytology (FNAC) and cell blocks were done for 225 cutaneous and subcutaneous nodules. Furthermore, histopathological examination was conducted using biopsies. Results: According to tissue biopsy, benign lesions constituted the most common finding in 180 (80%) cases. The detected cases were lipoma in 35 (15.5%) cases, adipose tissues in 30 (13.3%) cases, 20 fibro lipomas (8.8%), 20 fibromas (8.8%), 5 juvenile fibroma (2.2%), neurofibroma in 5 cases (2.2%), sebaceous cyst in 25 cases (11.1%), implantation cyst, or dermoid cyst 20 cases (8.8%), pilomatrixoma 5 cases (2.2%), seborrheic keratosis10 cases (4.4%) and Madura foot (actinomycosis) in 5 cases (2.2%). Intermediate lesions of atypical lipoma were found in 20 cases (8.8%). Malignant lesions were 25 cases (11.11%) as follows: 10 cases (4.4%) basal cell carcinoma, 10 cases (4.4%) squamous cell carcinoma and 5 cases (2.2%) basosquamous cell carcinoma. For FNAC smear examination, the sensitivity test was 83.01% and the specificity was 16.66%. For cell blocks examination, the sensitivity and specificity tests were 97.77%, and 100%, respectively. Conclusion: Smear cytology is an easy and quick test for diagnosing skin nodules. Performance of cell blocks improves sensitivity and specificity of smear outcome, but both should be attempted, because the smear may be ineffective in some cases while a cell block cannot be performed in others.
... Cyto-histological correlation in vascular tumours Vascular tumours in the present study included 21 tumours, 16 of which were confirmed on histopathology, all were accurately diagnosed and comprised of hemangioma(12), lymphangioma(3) and arteriovenous malformation (1) thus, giving us a concordance of 100 % which was comparable to P Arul et al 24 (2016) and Soni et al. 21 Perez-Guillermo et al 25 stated that the cytopathological findings of vascular tumours, evaluated in the context of clinical findings are sufficiently characteristic to be able to make a definitive diagnosis . Awasthi 26 concluded that a confident diagnosis of lymphangioma can usually be made on cytology. ...
... There was 1 false positive case cytologically diagnosed as malignant spindle cell tumor but histopathologically diagnosed as Pleomorphic lipoma [ Table 4]. [3,4]. ...
... Vijayabharathi et al. also reported the most common benign tumor as Schwannoma, Fibrosarcoma as most common malignant tumor [6]. Soni PB et al. reported neurofibroma as most common benign spindle cell tumor, MPNST as most common malignant tumor [4]. ...
Introduction: Spindle cell tumors constitute an important component of soft tissue tumors. Fine needle aspiration cytology provides a predictive diagnosis of type and nature of these neoplasms. Methods: This study was conducted for a period of four years. Results: A total of 124 cases were diagnosed as soft tissue spindle cell tumors cytologically. Of these, 86 (69.35%) cases were benign and 38 (30.64%) were malignant tumors. 52 cases were available for histopathological follow up of which 49 cases (94.23%) showed positive correlation. Though there are no specific tissue architectural patterns in cytological smears, they are helpful in providing predictive diagnosis of benign or malignant nature of the tumour and in many cases also of specific tumor type. However, histopathology is considered as “gold standard” in diagnosing spindle cell tumors. Ancillary techniques are helpful in providing definitive diagnosis thus increasing the diagnostic accuracy of FNAC. There were 2 false negative cases which were cytologically diagnosed as Schwannoma and Neurofibroma because of the presence of wavy spindle cells and blood but both cases were diagnosed as malignant peripheral nerve sheath tumor on histopathology. There was 1 false positive case cytologically diagnosed as malignant spindle cell tumor but histopathologically diagnosed as Pleomorphic lipoma. Conclusion: Cytological and histopathological correlation was available in 36 benign tumors and 16 malignant tumors. Among benign tumors, 94.44% (34 cases) showed positive correlation, 5.56% (2 cases) showed negative correlation. Whereas among malignant tumors, 93.75% (15 cases) showed positive correlation and 6.25% (1 case) showed negative correlation between cytologic and histopathologic diagnosis.
... In our study, cytologically diagnosed benign soft tissue tumors were found to be more common in upper limb, as also reported by Tailor HJ et al and Soni PB et al. [4,5]. While in the study by Vijayabharathi et al, lower limb was the most common site. ...
... Previous studies have also reported similar findings. [4,5,6]. ...
... Soni et al also reported P-value <0.0001, in their study. [5] The problems that we encountered:1) It was difficult to make diagnosis when too much blood was present in the aspirates or material was insufficient. This fact was supported in the studies by Patel MM et al and Rasool Z et al. [2,12] 2)A great difficulty was faced in grading and subtyping of spindle cell lesions based on cytological features. ...
... Our findings were similar to the study done by Soni PB et al, who also reported DFSP as the commonest malignant lesion. 12 In the series by Sharath Kumar HK et al, malignant fibrous histiocytoma was the most common malignant tumor. 11 ...
... -La aplicación de la ecuación mKJMA a la TGK de diversas variedades histológicas de tumores que crecen en diferentes tipos de ratones inmunocompetentes e inmunodeficientes. Actualmente las investigaciones experimentales [168][169][170][171][172][173][174] y/o teórico [175][176][177][178][179][180][181][182][183] se enfocan al entendimiento de la génesis del cáncer y de su TGK para la propuesta de terapias personalizadas [184,185]. ...
SINTESIS
La electroterapia se usa en el cáncer y es simple, efectiva, induce efectos adversos mínimos y se puede aplicar cuando las terapias oncoespecíficas fracasan. El objetivo general de esta tesis es evaluar el daño tisular y la cinética de crecimiento tumoral bajo la acción de la electroterapia con diferentes geometrías del arreglo de electrodos. Los efectos de esta terapia se determinan en ratones sanos C57BL/6/Cenp y en BALB/c/Cenp portadores de tumores. En los animales sanos se analizan los parámetros hematológicos, bioquímicos e histológicos mientras que en los portadores de tumores se describen las cinéticas del fibrosarcoma Sa-37 no tratado (ecuaciones de Gompertz, Logística y Avrami) y del carcinoma F3II tratado con esta terapia (ecuación de Gompertz modificada). Se determina el patrón espacial que adopta el daño tisular en piezas de papa bajo la acción de la electroterapia y se hace un planteamiento de problema (ecuaciones en derivadas parciales más condiciones de frontera) para proponer nuevas geometrías de arreglos de electrodos. Los resultados evidencian que la electroterapia induce daño tisular alrededor de los electrodos, tanto en ratones como en piezas de papa. La efectividad global de la electroterapia es ≥ 75 % en el 59,3 % de los tumores F3II tratados. Las ecuaciones de Gompertz, la Logística y la de Avrami modificada se pueden usar indistintamente para describir la cinética de crecimiento del tumor fibrosarcoma Sa-37. Se evidencia que del daño tisular es circular alrededor de los electrodos y adopta el patrón espacial de la geometría del arreglo de electrodos. El arreglo concéntrico de electrodos distribuye las líneas de densidad de corriente en todo el volumen tumoral con el mínimo daño al tejido sano circundante. Se concluye que las alteraciones que induce esta terapia en los ratones sanos son reversibles; la electroterapia induce un retardo significativo del crecimiento de los tumores altamente invasivos y metastásicos en dependencia de la de la razón i/i0, del tiempo de exposición y del género; la ecuación de Avrami modificada es adecuada para describir el crecimiento del fibrosarcoma Sa-37 no tratado y confirma que la cinética tumoral es de transformaciones intrínsecas estructurales dinámicas; el patrón espacial del daño tisular en piezas de papa adopta la misma forma del arreglo de electrodos y la inserción de múltiples electrodos concéntricos de agujas rectas a lo largo de la profundidad y la dirección radial de crecimiento del tumor puede mejorar la efectividad de esta terapia.
... Soni et al found 11 cases of fibrohistiocytic cases and found solid cell clusters and dispersed spindle shaped cells, thereby giving predominantly a spindle cell smear pattern in cytology smears. 15 The second most common benign lesion was observed as ganglion cyst 14(13.5%) which on aspiration showed histiocyte like cells in myxoid background and thus findings were similar to the study done by Dodd LG et al who also found thick, gelatinous fluid and a smear comprised of histiocytes embedded in a mucoid matrix. ...
... The findings were in accordance with study done by Soni et al which found majority of the smears poor in cells and showed blood only. 15 9 cases (8.7%) were categorized as benign spindle cell lesion. On aspiration, smears showed fragments of loose and tight clusters of oval to spindle cells having uniformly distributed chromatin and minimal pleomorphism. ...
BACKGROUND
Soft tissues are the nonepithelial extraskeletal connective tissues of the body, excluding supporting tissues of the internal organs,
glia and hematopoietic tissues. FNAC of soft tissue swelling is becoming more popular recently because of being minimally
invasive technique, relatively cheap cost and safety along with fair specificity and sensitivity.
AIM
To review the role of FNAC in diagnosing soft tissue tumours and to establish cytological criteria for the most encountered STT.
METHODS
This retrospective study was done in Department of Pathology for a period two years. A total of 4508 FNA were performed. 104
aspirations were done from soft tissue swellings. Air dried and wet fixed smears were stained with Giemsa and Papanicolaou
stain respectively.
RESULTS
Among 104 STT, 86 (82.3%) were diagnosed as benign lesions while 18 cases (17.3%) were malignant. Benign lesions-17
(16.3%) patients were diagnosed as benign fibrous histiocytoma followed by ganglion cyst in 14(13.5%) cases. 13 cases
(12.5%) were diagnosed as haemangioma while 9 cases (8.7%) were categorized as benign spindle cell lesion. 6 cases (5.8%)
each of neurofibroma and GCT of tendon sheath were reported. 6 infants (5.8%) were diagnosed as infantile fibromatosis. 5
cases (4.7%) were reported as schwannoma. 3 cases (2.9%) each of proliferative fasciitis and nodular fasciitis were diagnosed.
There were 3 cases (2.9%) reported as lymphangioma. One case (1%) was diagnosed as desmoid fibromatosis. Malignant
lesions-Among them, 3 cases (2.9%) were reported as MFH. Biphasic synovial sarcoma was diagnosed in 2 patients (1.9%). 2
cases (1.9%) were reported as low grade myxoid sarcoma. 1 case (1%) was diagnosed as MPNST. GIST was diagnosed in
1(1%) patient. One (1%) of the patients presented with swelling in scapular region. This was categorized under malignant
round cell tumour category. 8 cases (7.6%) were diagnosed as undifferentiated pleomorphic sarcoma.
CONCLUSION
With adequate material, FNAC has a definite role in diagnosing soft tissue tumours both benign and malignant in majority of
cases with no need for histopathology except in few tumours where overlapping cytological features still remain a big limitation.
