Fine‐needle aspiration cytology and core biopsy of malignant peripheral nerve sheath tumor of the uterus: A case report

Abstract

Malignant peripheral nerve sheath tumor (MPNST) is an uncommon mesenchymal neoplasm of neural origin. MPNST arising in the uterus is extremely rare. Its histologic appearance on this anatomical location has been only rarely reported. A 62-yr-old woman with a previous history of partial hysterectomy presented with a large pelvic mass in the uterine stump. Fine-needle aspiration (FNA) and core biopsy were obtained under ultrasonographic guidance, and the diagnosis of MPNST was established. The cytologic and histologic findings were consistent with a spindle-cell neoplasm suggestive of MPNST. The tumor cells were focally positive for S-100 protein immunostain, thus providing further support for the neoplasm's nerve sheath differentiation. The patient had no history of von Recklinghausen's disease. Resection of the mass confirmed the diagnosis of MPNST. To our knowledge, the FNA cytology of MPNST in this unusual location has not been previously reported. FNA cytology, along with core biopsy and immunochemistry, is a reliable tool in the diagnosis of MPNST.

Cytohistologic correlations of 24 malignant peripheral nerve sheath tumor (MPNST) in 17 patients: The Institut Curie experience

“…1 A review of the reported data concerning spindle-cell MPNST reveals that the most reliable morphological characteristic of well-differentiated tumors is the presence of typical comma-shaped cells, occasionally arranged in palisades, in conjunction with highly characteristic twisted or wavy nuclei. 4 -7 Molina et al 16 and Jiménez-Heffernen et al 1 reported that neurogenic differentiation was recogniz- able in all their cases: the smears showed spindle-shaped cells with elongated, slender, often wavy nuclei and a delicate, fibrillary metachromatic stroma in the background. Although well-differentiated MPNST can be diagnosed by cytological methods, it has been reported that anaplastic tumors may cause serious problems due to similarities with other types of pleomorphic sarcoma.…”

“…The cytologic criteria of MPNST have been described in a series of studies including 55 tumors in 49 patients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Preexisting neurofibroma or a history of neurofibromatosis 1 were noted in nine patients. 1,3,4,6 -8,10 Of 29 cases of primary and 24 cases of recurrent/metastatic listed in the literature, 45 tumors were correlated with histology and 22 were well-differentiated, five anaplastic, 1,2 four epithelioid, 1,9 one malignant Triton tumor 1 and two malignant melanotic schwannomas.…”

“…The differential diagnosis of MPNST includes benign forms of nerve sheath tumors and other types of spindle-cell sarcoma, principally synovial sarcoma, fibrosarcoma, and leiomyosarcoma. 1,8,12,13,[15][16][17] The benign nerve sheath tumors are characterized by loose tissue fragments with a fibrillar background and more cellular clusters of spindle cells representative of Verocay bodies. 22 However, vascular arcades, fishhook nuclei, and epithelioid cells were also reported.…”

“…In consonance with the great histopathological diversity, cytologic correlations, except for one publication, 1 are limited to single case reports or small series. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] To better define the cytological patterns in MPNST, we reviewed the cytology and corresponding histology materials of patients diagnosed and treated at our institution.…”

Tumor Maligno de la Vaina del Nervio Periférico del Mediastino en un Paciente con Neurofibromatosis Tipo 1

“…En estas células se puede observar ligera irregularidad nuclear y ocasionales mitosis (McGee et al, 1997;Jiménez-Heffernan et al, 1999). Al complementar el estudio con inmunocitoquímica, se puede mejorar su rendimiento diagnóstico (Molina et al, 2001). Por otro lado, en las muestras obtenidas por punción con aguja gruesa, se observan lesiones marcadamente celulares con diferenciación neural, acompañadas de mitosis frecuentes y áreas de necrosis geográfica (Molina et al).…”