Bone and soft tissue sarcomas in cerebrospinal fluid and effusion: A 20‐year review at our institution

Abstract

BACKGROUND:The literature on bone and soft tissue sarcomas (BSTSs) involving effusions and cerebrospinal fluid (CSF) is very limited. METHODS: A computerized search for fluid cytology with a sarcoma diagnosis from 2000 to 2020 was performed. All available cases, including the clinical follow-up, were reviewed. RESULTS: A total of 57 fluids specimens from 36 BSTSs were identified (9 rhabdomyosarcomas, 6 angiosarcomas, 5 epithelioid hemangioendotheliomas, 3 dedifferentiated liposarcomas, 2 chondrosarcomas, 1 extraskeletal myxoid chondrosarcoma, 3 Ewing sarcomas, 2 undifferentiated sarcomas, 3 osteosarcomas, 1 synovial sarcoma, and 1 hybrid low-grade fibromyxoid sarcoma/sclerosing epithelioid fibrosarcoma).There were 22 males and 14 females. The age range was 4 to 82 years (median, 45 years). Sites of involvement included pleural fluid (n = 38), peritoneal fluid (n = 14), and CSF (n = 5). Twenty-four cytology cases were available for review. The cytologic features were nonspecific and ranged from dyshesive to clusters of round, epithelioid, pleomorphic, and occasionally spindle-shaped malignant cells that could easily mimic other non-BSTS malignant tumors. The diagnosis of BSTS was made by comparison with a prior specimen and/or ancillary studies (molecular or immunohistochemical stains). The prognosis was poor because 95% of the patients died of their disease. CONCLUSIONS: The incidence of BSTS in fluid cytology is extremely rare, and it can have cytologic features similar to those of non-BSTS malignancies. Although, in most cases, a comparison with a prior known BSTS specimen may suffice, the use of ancillary studies is extremely helpful in arriving at the correct diagnosis. However, in cases with no known prior malignancy, including BSTS in the differential diagnosis is prudent for preventing misdiagnosis.

Sarcomas in fluid cytology: Experience from a tertiary care centre in India

“…The largest study examined 20 years' worth of data from their institute and involved 36 cases of bone and soft tissue sarcomas in CSF and effusion fluids. 4 They had a broader range of cases than we did, such as adipocytic and undifferentiated sarcomas, which we did not see in our study. However, we observed two cases of MPNST exfoliation in pleural fluid, which has only been documented in one other study.…”

Cytomorphology of NUTM1‐rearranged sarcoma involving pleural fluid

“…In general, the diagnosis of sarcoma on fluid cytology can be extremely challenging because of its rarity 3 . In majority of the cases, a cytological diagnosis of sarcoma was rendered based on a known diagnosis of sarcoma and comparison of the patient's prior specimen.…”

“…The incidence of soft tissue sarcomas involving effusions is extremely rare, and it accounts for <5% of malignant effusions. [1][2][3] NUTM1rearranged sarcoma is a newly described and emerging class of mesenchymal neoplasm that its histopathology remains poorly defined. 4 NUTM1-rearranged sarcomas have been reported in a variety of different somatic soft tissue locations, with isolated cases in visceral organs.…”

“…The incidence of soft tissue sarcomas involving effusions is extremely rare, and it accounts for <5% of malignant effusions 1–3 . NUTM1 ‐rearranged sarcoma is a newly described and emerging class of mesenchymal neoplasm that its histopathology remains poorly defined 4 .…”

Liposarcoma Involving Serous Fluid Cavities—A Case Series Illustrating Clinical Implications and the Diagnostic Role of Exfoliative Cytology

“…Literature search yielded 2 case series and 2 case reports (Table 3). The case series by Sharma et al 10 described 2 patients of dedifferentiated liposarcoma and 1 liposarcoma, not specified, and another by Abadi et al 11 included 3 patients of liposarcoma without specifying the subtype. Both described high-grade cytological features including marked pleomorphism, nuclear irregularity, and distinct red nucleoli, but no cytological evidence of lipomatous differentiation (ie, atypical adipocytes or lipoblasts) was discussed.…”