FNA Cytology of Soft Tissue and Bone Tumors

Abstract

Fine-needle aspiration cytology (FNAC) has been commonly used to follow up on previously treated sarcomas or to confirm soft tissue and bone metastases of carcinomas, melanomas or lymphomas. Its role as the firstline approach in the diagnosis of primary soft tissue and bone tumors has increased due to progress of less invasive diagnostic procedures and the growing availability of diagnostic ancillary tests.This comprehensive and richly-illustrated volume presents cytomorphology of all common neoplastic soft tissue and bone lesions but also of rare tumors largely described in case reports. Key points for cytological features, differential diagnosis, and the use of ancillary tests are discussed and illustrated in order to facilitate the diagnostic work-up in FNA samples.The volume is organized on the basis of the most recent WHO classification used in surgical pathology in order to provide a practical guide for modern cytologic diagnosis of surgical soft tissue and bone pathology. It is aimed mainly at surgical pathologists and cytopathologists, but also at orthopedic surgeons and clinical oncologists. CoNTeNTS

Functional Outcomes of Limb Salvage Surgery in Patients with Giant Cell Tumor of Bone of the Lower Extremities: A Retrospective Study

“…GCTB accounts for only 5% of all primary bone tumors [1][2][3][4][5][6]9,15,16,18,20] and are known to be locally aggressive benign tumors, and a propensity to be highly recurrent but with a rare metastatic potential [1,5,6,14,15] . Most of these lesions develop in long bones (75%-90%), with majority of cases (50-65%) occurring adjacent to the knee [2,5,6,9,16,18] .…”

“…Giant cell tumor of the bone (GCTB) is a benign but locally aggressive neoplasm comprising approximately 5% of all primary bone tumors [1][2][3][4][5][6]9,15,16,18,20] . The natural history of GCTB is progressive bone destruction leading to joint deformity and disability, and despite it rarely causing death, it displays a tendency for local recurrence occurring within two years of the index surgery, and pulmonary metastasis (1.8-9.1% of cases) has also been described [1,2,5,6,14,15,21] . There are documented cases of malignant transformation in less than 1% of GCTs and are hence considered rare [1,5,6] .…”

“…The natural history of GCTB is progressive bone destruction leading to joint deformity and disability, and despite it rarely causing death, it displays a tendency for local recurrence occurring within two years of the index surgery, and pulmonary metastasis (1.8-9.1% of cases) has also been described [1,2,5,6,14,15,21] . There are documented cases of malignant transformation in less than 1% of GCTs and are hence considered rare [1,5,6] .…”

Fine-Needle Aspiration Cytology in Preoperative Diagnosis of Bone Lesions: A Three-Year Study in a Tertiary Care Hospital

“…A core or open biopsy is advisable in such fibrotic lesions. The reported diagnostic accuracy for OSs on FNAC has ranged from 33 to 76% [7, 14, 18-20].…”

FNA of epithelioid sarcoma: Curie Institute experience and critical review of the literature

“…Rather than epithelioid cells, smears from this entity demonstrate dispersed or loosely cohesive spindle cells with cytoplasmic extensions that resemble those from nodular fasciitis. 23 Moreover, ES can be confused with benign granulomatous processes (if a granuloma-like appearance predominates), such as granuloma annulare and rheumatoid nodule (pan-CK and EMA negative; INI1 positive). Accurate diagnosis is aided by immunohistochemical testing.…”