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Fine-needle aspiration of neurilemoma (schwannoma). A clinicocytopathologic study of 116 patients

Domanski, Henryk A LU ; Åkerman, Måns LU ; Engellau, Jacob LU ; Gustafson, Pelle LU ; Mertens, Fredrik LU and Rydholm, Anders LU (2006) In Diagnostic Cytopathology 34(6). p.403-412
Abstract

The preoperative fine-needle aspiration cytology (FNAC) diagnoses in 116 surgically excised neurilemomas were reviewed and compared with the corresponding histopathologic diagnoses made on surgical specimens and with clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, benign diagnosis was rendered by FNAC in 80 cases, 67 of which were correctly labelled as neurilemoma in a review of the original cytology reports. There were 6 false-positive malignant diagnoses while 23 smears were considered insufficient and 7 inconclusive as to whether benign or malignant. On reevaluation, the diagnostic smears in most cases contained... (More)

The preoperative fine-needle aspiration cytology (FNAC) diagnoses in 116 surgically excised neurilemomas were reviewed and compared with the corresponding histopathologic diagnoses made on surgical specimens and with clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, benign diagnosis was rendered by FNAC in 80 cases, 67 of which were correctly labelled as neurilemoma in a review of the original cytology reports. There were 6 false-positive malignant diagnoses while 23 smears were considered insufficient and 7 inconclusive as to whether benign or malignant. On reevaluation, the diagnostic smears in most cases contained spindle cells with wavy nuclei embedded in a fibrillar, occasionally collagenous, and/or myxoid matrix and Antoni A/Antoni B tissue fragments. A moderate to abundant admixture of round to oval cells was also frequent. Nuclear palisading was seen in 41 smears with distinctive Verocay bodies in 10. Markedly pleomorphic nuclei were seen in smears from 8 ancient and 6 conventional neurilemomas, and slight to moderate nuclear pleomorphism was observed in 38 additional cases. Thus most neurilemomas have distinct cytomorphologic features that allow correct diagnosis. The major problem in FNAC of neurilemoma is to obtain sufficient material. Furthermore aspirates showing predominantly Antoni A features, nuclear pleomorphism, and/or myxoid changes can easily be confused with other types of benign or malignant soft-tissue tumors.

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keywords
Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers, Tumor, Biopsy, Fine-Needle, Diagnosis, Differential, False Positive Reactions, Female, Humans, Male, Middle Aged, Neurilemmoma, S100 Proteins, Sarcoma, Sensitivity and Specificity, Soft Tissue Neoplasms, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
in
Diagnostic Cytopathology
volume
34
issue
6
pages
10 pages
publisher
John Wiley & Sons
external identifiers
  • wos:000237752500003
  • pmid:16680779
  • scopus:33646818948
  • pmid:16680779
ISSN
8755-1039
DOI
10.1002/dc.20449
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Clinical Genetics (013022003), Oncology, MV (013035000), Pathology, (Lund) (013030000), Department of Orthopaedics (Lund) (013028000)
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fedca144-11ff-4a42-a712-8f870b5425b3 (old id 156935)
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16680779&dopt=Abstract
date added to LUP
2016-04-01 11:50:09
date last changed
2019-12-01 03:46:23
@article{fedca144-11ff-4a42-a712-8f870b5425b3,
  abstract     = {<p>The preoperative fine-needle aspiration cytology (FNAC) diagnoses in 116 surgically excised neurilemomas were reviewed and compared with the corresponding histopathologic diagnoses made on surgical specimens and with clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, benign diagnosis was rendered by FNAC in 80 cases, 67 of which were correctly labelled as neurilemoma in a review of the original cytology reports. There were 6 false-positive malignant diagnoses while 23 smears were considered insufficient and 7 inconclusive as to whether benign or malignant. On reevaluation, the diagnostic smears in most cases contained spindle cells with wavy nuclei embedded in a fibrillar, occasionally collagenous, and/or myxoid matrix and Antoni A/Antoni B tissue fragments. A moderate to abundant admixture of round to oval cells was also frequent. Nuclear palisading was seen in 41 smears with distinctive Verocay bodies in 10. Markedly pleomorphic nuclei were seen in smears from 8 ancient and 6 conventional neurilemomas, and slight to moderate nuclear pleomorphism was observed in 38 additional cases. Thus most neurilemomas have distinct cytomorphologic features that allow correct diagnosis. The major problem in FNAC of neurilemoma is to obtain sufficient material. Furthermore aspirates showing predominantly Antoni A features, nuclear pleomorphism, and/or myxoid changes can easily be confused with other types of benign or malignant soft-tissue tumors.</p>},
  author       = {Domanski, Henryk A and Åkerman, Måns and Engellau, Jacob and Gustafson, Pelle and Mertens, Fredrik and Rydholm, Anders},
  issn         = {8755-1039},
  language     = {eng},
  number       = {6},
  pages        = {403--412},
  publisher    = {John Wiley & Sons},
  series       = {Diagnostic Cytopathology},
  title        = {Fine-needle aspiration of neurilemoma (schwannoma). A clinicocytopathologic study of 116 patients},
  url          = {https://lup.lub.lu.se/search/ws/files/2663946/625467.pdf},
  doi          = {10.1002/dc.20449},
  volume       = {34},
  year         = {2006},
}