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Fine needle aspiration diagnosis of spindle cell tumors of soft tissue, including the use of ancillary methods, and correlation with clinical data.

Domanski, Henryk LU (2005)
Abstract
Fine needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of soft tissue lesions. FNAC used as a primary examination method to obtain a morphologic diagnosis, has been part of the diagnostic work-up of patients admitted to the Musculoskeletal Tumor Center of the Lund University Hospital since 1972. Accuracy of FNAC in distinguishing benign from malignant soft tissue tumors has been comparable to that of surgical biopsies, while its accuracy in establishing a specific subtype diagnosis has been inferior to surgical biopsies.



The cytological examination of spindle cell tumors of soft tissue, which often share morphological and clinical characteristics, is a challenge. In addition, the... (More)
Fine needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of soft tissue lesions. FNAC used as a primary examination method to obtain a morphologic diagnosis, has been part of the diagnostic work-up of patients admitted to the Musculoskeletal Tumor Center of the Lund University Hospital since 1972. Accuracy of FNAC in distinguishing benign from malignant soft tissue tumors has been comparable to that of surgical biopsies, while its accuracy in establishing a specific subtype diagnosis has been inferior to surgical biopsies.



The cytological examination of spindle cell tumors of soft tissue, which often share morphological and clinical characteristics, is a challenge. In addition, the literature on FNAC of spindle cell tumors is still sparse.



The purpose of this study was both to describe the spectrum of FNAC findings in spindle cell tumors of soft tissue and also to analyze which ancillary methods can optimize FNA cytodiagnosis among these tumors in order to minimize the need for open biopsy.



To this end, 238 FNA aspirates performed on 236 patients with five selected types of spindle cell tumors of soft tissue were analysed. In addition, clinical information and ancillary studies, which could increase the precision of cytodiagnosis were evaluated.



The results of the study indicate the following:



Different treatment options for some low grade and local aggressive/benign spindle cell tumors require an exact histotype diagnosis. This can be usually obtained from aspiration smears complemented by clinical data in elastofibroma dorsi and spindle cell lipoma due to their characteristic cytomorphology. FNAC evaluation of neurilemoma (schwannoma), leiomyosarcoma and dermatofibrosarcoma protuberans, requires the use of strict cytological criteria together with proper clinical information and often ancillary techniques.



Correct cytologic diagnosis of spindle cell tumors is facilitated when fine needle aspiration cytology is used in the context of the clinical findings and when the cytological diagnosis is based on strict cytological criteria as well as ancillary techniques. (Less)
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author
supervisor
opponent
  • Professor Hagmar, Björn, Oslo, Norge
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Patologi (allmän), patologisk anatomi, General pathology, pathological anatomy, spindle cell lipoma, soft tissue, spindle cell tumors, Medicine (human and vertebrates), Medicin (människa och djur), schwannoma, neurilemoma, leiomyosarcoma, immunocytochemistry, FNA, fine needle aspiration, dermatofibrosarcoma protuberans, elastofibroma dorsi, Cytology, electron microscopy
pages
162 pages
publisher
Department of Patology & Cytology Lund University Hospital 221 85 Lund Sweden
defense location
Föreläsningssalen, Patologiska/Cytologiska kliniken, Universitetssjukhuset, Lund.
defense date
2005-12-16 13:00:00
ISBN
91-85481-21-1
language
English
LU publication?
yes
additional info
HA Domanski, B Carlén, K Jonsson, F Mertens and M Åkerman. 2001. Distinct cytologic features of spindle cell lipoma. A cytologic-histologic study with clinical, radiologic, electron microscopic and cytogenetic correlations. Cancer, vol 93 pp 381-389.
HA Domanski and P Gustafson. 2002. Cytologic features of primary, recurrent, and metastatic dermatofibrosarcoma protuberans. Cancer, vol 96 pp 351-361.
HA Domanski. 2005. FNA diagnosis of dermatofibrosarcoma protuberans. Diagn Cytopathol, vol 32 pp 299-302.
HA Domanski, B Carlén, M Sloth and A Rydholm. 2003. Elastofibroma dorsi has distinct cytomorphologic features making diagnostic surgical biopsy unnecessary: a cytomorphologic study with clinical, radiological and electron microscopic correlations. Diagn Cytopathol, vol 29 pp 327-333.
HA Domanski, M Åkerman, J Engellau, P Gustafson, F Mertens and A Rydholm. . Fine-needle aspiration of neurilemoma. A clinicocytopathologic study of 116 patients. (accepted)
HA Domanski, M Åkerman, P Rissler and P Gustafson. . Fine needle aspiration of soft tissue leiomyosarcoma. An analysis of the most common cytologic findings and the value of ancillary techniques. (submitted)
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000)
id
5ee64f70-6acd-449e-87ee-a3f583c30f7c (old id 545968)
date added to LUP
2016-04-04 10:13:58
date last changed
2025-04-04 15:26:27
@phdthesis{5ee64f70-6acd-449e-87ee-a3f583c30f7c,
  abstract     = {{Fine needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of soft tissue lesions. FNAC used as a primary examination method to obtain a morphologic diagnosis, has been part of the diagnostic work-up of patients admitted to the Musculoskeletal Tumor Center of the Lund University Hospital since 1972. Accuracy of FNAC in distinguishing benign from malignant soft tissue tumors has been comparable to that of surgical biopsies, while its accuracy in establishing a specific subtype diagnosis has been inferior to surgical biopsies.<br/><br>
<br/><br>
The cytological examination of spindle cell tumors of soft tissue, which often share morphological and clinical characteristics, is a challenge. In addition, the literature on FNAC of spindle cell tumors is still sparse.<br/><br>
<br/><br>
The purpose of this study was both to describe the spectrum of FNAC findings in spindle cell tumors of soft tissue and also to analyze which ancillary methods can optimize FNA cytodiagnosis among these tumors in order to minimize the need for open biopsy.<br/><br>
<br/><br>
To this end, 238 FNA aspirates performed on 236 patients with five selected types of spindle cell tumors of soft tissue were analysed. In addition, clinical information and ancillary studies, which could increase the precision of cytodiagnosis were evaluated.<br/><br>
<br/><br>
The results of the study indicate the following:<br/><br>
<br/><br>
Different treatment options for some low grade and local aggressive/benign spindle cell tumors require an exact histotype diagnosis. This can be usually obtained from aspiration smears complemented by clinical data in elastofibroma dorsi and spindle cell lipoma due to their characteristic cytomorphology. FNAC evaluation of neurilemoma (schwannoma), leiomyosarcoma and dermatofibrosarcoma protuberans, requires the use of strict cytological criteria together with proper clinical information and often ancillary techniques.<br/><br>
<br/><br>
Correct cytologic diagnosis of spindle cell tumors is facilitated when fine needle aspiration cytology is used in the context of the clinical findings and when the cytological diagnosis is based on strict cytological criteria as well as ancillary techniques.}},
  author       = {{Domanski, Henryk}},
  isbn         = {{91-85481-21-1}},
  keywords     = {{Patologi (allmän); patologisk anatomi; General pathology; pathological anatomy; spindle cell lipoma; soft tissue; spindle cell tumors; Medicine (human and vertebrates); Medicin (människa och djur); schwannoma; neurilemoma; leiomyosarcoma; immunocytochemistry; FNA; fine needle aspiration; dermatofibrosarcoma protuberans; elastofibroma dorsi; Cytology; electron microscopy}},
  language     = {{eng}},
  publisher    = {{Department of Patology & Cytology Lund University Hospital 221 85 Lund Sweden}},
  school       = {{Lund University}},
  title        = {{Fine needle aspiration diagnosis of spindle cell tumors of soft tissue, including the use of ancillary methods, and correlation with clinical data.}},
  year         = {{2005}},
}