Role of fine needle aspiration cytology in the diagnosis of soft tissue tumours and tumour‐like lesions

Abstract

In this study, we evaluated the usefulness of fine needle aspiration cytology (FNAC) in the diagnosis of soft tissue tumours. We have also assessed the various pitfalls of FNAC of soft tissue tumours. This was a retrospective study and here we analysed only 82 histopathology proven cases of FNAC of soft tissue tumours diagnosed in a five and half year period. On histopathological examination, 55 of these cases were malignant and 27 were benign. There was a total of 15 recurrences and histopathology was available prior to FNAC in only eight of these cases. Therefore, excluding these eight cases, malignant tumours were primarily diagnosed by FNAC in 47 cases. The sensitivity, specificity and positive predictive value of FNAC in diagnosis of soft tissue tumours were 91.5%, 92.5% and 95.5%, respectively. Only 22 of 47 cases (46.8%) were correctly categorized. There were two false-positive and four false-negative cases. One case each of fibromatosis and schwannoma were reported as sarcoma. False-negative cases were fibrosarcoma (1), malignant nerve sheath tumour (2) and haemangiopericytoma (1). FNAC was very useful in distinguishing benign from malignant soft tissue tumours. However, it was not so effective in exact categorization of tumours.

Fine-needle aspiration cytology and core needle biopsy in the preoperative diagnosis of desmoid tumors

“…There have been very few reports in the literature on the application of FNA in the preoperative diagnosis of desmoids (Raab et al 1993, Powers et al 1994, Åkerman 2003, Dey et al 2004. Our review of 69 fine-needle aspirates of desmoids clearly shows its usefulness.…”

“…There have been only a few published studies of single cases or relatively small series of desmoids examined by FNA, with some indicating its usefulness (Raab et al 1993(Raab et al , Åker-man 2003 and others pointing out the pitfalls of occasional misinterpretation of malignancies (Powers et al 1994, Dey et al 2004). The few reports of core needle biopsies in the preoperative diagnosis of desmoids suggest that it is a very useful technique (Serpell andPitcher 1998, RayCoquard et al 2003).…”

Diagnostic accuracy and limitations of fine‐needle aspiration cytology of bone and soft tissue lesions

“…However, FNA biopsies can have sampling errors attributed to low cellularity, inadequate sampling of the target, and copious cystic/bloody/necrotic material. 2 Despite these difficulties, FNA cytology is being used as a diagnostic modality for initial diagnoses, as well as for recurrences and metastases of soft tissue and bone lesions in numerous medical centers, 8,10,12,14,[18][19][20][21][22][23][24][25] because of its simplicity, low morbidity, cost effectiveness, and ability to issue rapid diagnoses that can facilitate clinical decision making.…”

“…2 Several factors have been implicated such as the low volume of soft tissue and bone lesions in most practices, the overlapping cytomorphologic features in a variety of entities, and the wide variability in reported sensitivities, specificities, and inadequacy rates over the past 2 to 3 decades, [2][3][4][5][6][7][8][9][10][11][12][13][14] leading to skepticism regarding the accuracy and utility of this technique. [15][16][17] The aims of the current study were to investigate the utility of FNA in the diagnosis of soft tissue and bone lesions in a large series of cases from a tertiary medical center with an active FNA service, and to highlight some of the challenges.…”

Schwannomas of Head and Neck and Review of Literature

“…FNAC is very effective in differentiating benign and malignant tumours of soft tissue. Although FNAC is very useful in most neck masses, it has a low accuracy in the diagnosis of neural tumours [8].…”