Long fascicular tissue fragments in desmoid fibromatosis by fine needle aspiration: A new cytologic feature

ArticleinDiagnostic Cytopathology 40(1):45-7 · January 2012with7 Reads
DOI: 10.1002/dc.21610 · Source: PubMed
  • [Show abstract] [Hide abstract] ABSTRACT: Deep fibromatosis or desmoid tumor (DF/DT) is a low-grade, soft tissue lesion that is notable for its infiltration and local recurrence and its inability to metastasize. Although the histologic features of DF/DT are well described, there is a paucity of literature regarding cytologic findings. The surgical pathology files of The Johns Hopkins Hospital revealed 17 patients with a diagnosis of DF/DT with prior cytology in a 16-year period (1989-2005). The clinicoradiologic findings were noted, and the fine-needle aspiration (FNA) slides were available for review in 8 patients. In patients with archived tissue, an immunohistochemical panel was performed that included beta-catenin, desmin, CD-34, and c-kit. There was a wide age range and a wide range of anatomic distribution for DF/DT in this series. Eleven patients (65%) had a prior history of surgery at or near the site of DF/DT. Radiologically, 5 of 11 patients (45%) who had in-house studies available and no history of DF/DT were diagnosed as suspicious for malignancy. Predominantly bland spindled cells with long, fusiform nuclei and metachromatic matrix material were present in most tumors. The tumor cells were present both singly and as fragments embedded in the matrix. Nine patients had paraffin-embedded tissue samples available for immunohistochemical staining. Six of those samples demonstrated nuclear beta-catenin reactivity, and all 9 samples were negative for desmin, CD-34, and c-kit. The current results indicated that clinical history in patients with suspected DF/DT is important. Because of the infiltrative nature of DF/DT, the radiographic impression often is over-called as suspicious for malignancy. The cytomorphology is nonspecific, often resulting in descriptive diagnoses. Immunohistochemical stains increase the yield of FNA.
    Full-text · Article · Jul 2007
  • [Show abstract] [Hide abstract] ABSTRACT: Desmoid tumors have a tendency to recur locally, and traditionally they have been treated surgically. No treatment is sometimes indicated, however; this requires a morphological diagnosis that is not based on a surgical specimen. In this study we aimed to identify the diagnostic accuracy of needle and core biopsy for the morphological diagnosis of desmoid. We compared the diagnostic accuracy of fine-needle aspiration (FNA) and core needle biopsy (CNB) in 69 and 26 patients, respectively, who had had surgical resections for desmoid. We also reviewed 15 additional cases that had been incorrectly diagnosed as desmoid on FNA but which had different diagnoses after surgery. FNA-based diagnoses of desmoid/fibromatosis were rendered in 35 of 69 cases, and other benign spindle cell proliferations in 26 cases and spindle cell sarcoma in the remaining 4 cases. All 26 CNBs were either suggested to correspond to desmoid (24) or other benign spindle cell lesions (2). Of the 15 FNAs incorrectly diagnosed as desmoid, 2 were found to be sarcomas. FNA is fairly reliable for recognition of the benign nature of desmoids. Occasional over- and under-diagnosis of malignancy can occur, however. CNB appears to be more reliable.
    Full-text · Article · Jan 2007
  • [Show abstract] [Hide abstract] ABSTRACT: Fine-needle aspiration (FNA) cytology was performed in seven cases of fibromatosis of variable types with tumorous clinical presentation. These included: four cases of musculoaponeurotic fibromatosis, two in posterior neck muscles, one in anterior neck muscles and one in intercostal muscles; one case of fibromatosis of the breast; and two cases of fibromatosis colli in neonates. In all cases the specimens contained connective tissue with many fibroblast-like cells, lacking features which could indicate a malignant lesion. The findings in these cases indicate that, although by FNA cytology in fibromatoses a specific diagnosis for each pathologic entity may not be easily reached, in the proper clinical setting the cytologic findings can be of sufficient relevance to offset the need for an open tissue biopsy, where there are valid reasons against a surgical intervention.
    Article · Jan 1992
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