Scope of FNAC in the diagnosis of soft tissue tumors-A study from a tertiary cancer referral center in India

Background Fine needle aspiration cytology (FNAC) forms one of the first diagnostic tools in the evaluation of tumors. Its role in diagnosing soft tissue tumors (STT) has been fairly documented, as well as debated. Present study was aimed at evaluating its scope in diagnosing 127 cases of soft tissue tumors. Methods Conventional Pap and MGG staining was available in all the cases. Immunocytochemistry (ICC) was performed in 15 cases. Histopathological details were available in 115 cases. Results 50% cases were referred for a primary diagnosis, while 26.8% & 22.8% cases were evaluated for recurrent and metastatic lesions, respectively. Extremities were the commonest sites. On FNAC, 101 cases (79.5%) were labeled as malignant, whereas 10 cases (7.9%) were labeled as benign. The remaining 16 cases (11%) were not categorized and were labeled as ‘unsure/not specified’. Histopathological confirmation in 115 cases, gave a diagnostic accuracy of 98%, with a positive predictive value of 98% in malignant cases and a negative predictive value of 100% in benign cases. Two cases were false positive. Among the various cytological categories, 60 cases (47.2%) were of spindle cell type, followed by 32 (25.2%) of round cell type and 14 cases (11%) of lipomatous type. Other 12 cases (9.4%) were of pleomorphic type; 7 (5.5%) cases of epithelioid type and remaining 2 cases were of myxoid type. All the round cell, pleomorphic and myxoid type of tumors were sarcomas, whereas 73.3% cases of spindle cell type were labeled as ‘malignant’. Exact cytological sub typing was offered in 58 cases, with rhabdomyosarcoma (RMS) as the most frequently sub typed tumor. The two false positive malignant cases were of fibromatosis and a pigmented schwannoma, on biopsy. Out of 28 metastatic lesions, lymph nodes were the commonest site for metastasis, with epithelioid tumors that formed highest percentage of metastatic cases. Conclusion FNAC is fairly specific and sensitive in STT diagnoses for primary, recurrent and metastatic lesions. The cytological types, especially round cell and pleomorphic sarcomas, can be quickly identified. Clinicopathological correlation with ICC as an adjunct, are valuable in exact sub typing.

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A case of spindle cell type anaplastic carcinoma of the pancreas presented rapidly aggressive liver metastasis

Pancreatology ◽

10.1016/j.pan.2016.06.432 ◽

2016 ◽

Vol 16 (4) ◽

pp. S120

Author(s):

Yu Nobuoka ◽

Taijiro Takeuchi ◽

Hiroyuki Yuasa ◽

Kanji Tanigawa ◽

Hajime Yokoi

Keyword(s):

Liver Metastasis ◽

Spindle Cell ◽

Anaplastic Carcinoma ◽

Cell Type ◽

Carcinoma Of The Pancreas ◽

Spindle Cell Type

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Cytokeratin-positive interstitial reticulum cell (CIRC) tumor in the lymph node: a case report of the transformation from the epithelioid cell type to the spindle cell type

Diagnostic Pathology ◽

10.1186/s13000-020-01032-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Sachiko Kaji ◽

Nobuyuki Hiruta ◽

Daisuke Sasai ◽

Makoto Nagashima ◽

Rintaro Ohe ◽

...

Keyword(s):

Tumor Cells ◽

Lung Carcinoma ◽

Spindle Cell ◽

Small Cell Lung Carcinoma ◽

Epithelioid Cell ◽

Small Cell ◽

Cell Type ◽

Small Cell Lung ◽

Cell Lung Carcinoma ◽

Spindle Cell Type

Abstract Background Cytokeratin-positive interstitial reticulum cells (CIRCs), which are a subgroup of fibroblastic reticular cells (FRCs), are known to be present in the lymph nodes. There have been only a few cases of tumors derived from CIRCs. Case presentation We have reported a new case involving a CIRC tumor in a 75-year-old man and reviewed the literature. The resected mediastinal lymph nodes showed epithelial-like proliferation of large atypical round and polygonal epithelioid cells. The tumor cells expressed CK8, CK18, CAM5.2, AE1/AE3, epithelial membrane antigen, vimentin, fascin, and some FRC markers, which is consistent with the diagnosis of a CIRC tumor. Following chemotherapy, the CIRC tumor was observed to have responded very well and became difficult to confirm on imaging, but a small cell lung carcinoma developed 12 months later. Chemoradiotherapy was performed, but the patient passed away 29 months after the initial diagnosis. The autopsy revealed the recurrence of the CIRC tumor, residual small cell lung carcinoma, and a very small latent carcinoma of the prostate. The relapsed CIRC tumor cells had a spindle shape; they were highly pleomorphic and had invaded the superior vena cava. Conclusion We first reported autopsy findings of CIRC tumors and demonstrated the transformation of the tumor from the epithelioid cell type to the spindle cell type.

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BCOR-CCNB3-positive soft tissue sarcoma with round-cell and spindle-cell histology: a series of four cases highlighting the pitfall of mimicking poorly differentiated synovial sarcoma

Histopathology ◽

10.1111/his.13001 ◽

2016 ◽

Vol 69 (5) ◽

pp. 792-801 ◽

Cited By ~ 25

Author(s):

Wan-Shan Li ◽

I-Chuang Liao ◽

Mei-Chin Wen ◽

Howard Haw-Chang Lan ◽

Shih-Chen Yu ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Synovial Sarcoma ◽

Spindle Cell ◽

Round Cell ◽

Poorly Differentiated

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A case of spindle cell type anaplastic carcinoma of the pancreas which developed acute pancreatitis

Suizo ◽

10.2958/suizo.31.85 ◽

2016 ◽

Vol 31 (1) ◽

pp. 85-92 ◽

Cited By ~ 1

Author(s):

Yousuke MICHIKAWA ◽

Kazunari NAKAHARA ◽

Keigo SUETANI ◽

Ryo MORITA ◽

Sarika KITAGAWA ◽

...

Keyword(s):

Acute Pancreatitis ◽

Spindle Cell ◽

Anaplastic Carcinoma ◽

Cell Type ◽

Carcinoma Of The Pancreas ◽

Spindle Cell Type

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Primary cutaneous follicle centre lymphoma, spindle cell type, presenting with multicentre figurated erythema and complete remission after intralesional injections of ultra‐low‐dose Interferon alpha‐2a

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.16942 ◽

2020 ◽

Author(s):

L. Vlahova ◽

W. Kempf ◽

M.P. Schön ◽

C. Mitteldorf

Keyword(s):

Complete Remission ◽

Interferon Alpha ◽

Low Dose ◽

Spindle Cell ◽

Cell Type ◽

Intralesional Injections ◽

Follicle Centre Lymphoma ◽

Spindle Cell Type

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Spindle cell carcinoma of the breast managed with neoadjuvant AIM: A case report

Rare Tumors ◽

10.1177/2036361320977021 ◽

2020 ◽

Vol 12 ◽

pp. 203636132097702 ◽

Cited By ~ 1

Author(s):

April Choi ◽

Philip M Carpenter ◽

Shefali Chopra ◽

Kristi M Lara ◽

William W Tseng ◽

...

Keyword(s):

Breast Cancer ◽

Case Report ◽

Cell Carcinoma ◽

Randomized Trials ◽

Spindle Cell ◽

Spindle Cell Carcinoma ◽

Metaplastic Carcinoma ◽

Cell Type ◽

Carcinoma Of The Breast ◽

Spindle Cell Type

Spindle cell carcinoma (SpC), also known as metaplastic carcinoma—spindle cell type, is a subtype of metaplastic carcinoma. Metaplastic carcinomas of the breast are rare but are thought to be more aggressive than invasive ductal carcinomas. Due to their rarity, there are few randomized trials that can inform any standardized approaches to treatment. Treatment is instead extrapolated from other types of breast cancer or metaplastic carcinomas of different locations. Here we present the first known case report of a patient with spindle cell carcinoma of the breast successfully treated with a standard sarcoma neoadjuvant regimen of doxorubicin, ifosfamide, and mesna (AIM) that resulted in >99% necrosis of the tumor and negative margins at the time of resection.

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Spindle Cell Lipoma of the Foot: A Case Report and Literature Review

Foot & Ankle International ◽

10.1177/107110079501600411 ◽

1995 ◽

Vol 16 (4) ◽

pp. 220-226 ◽

Cited By ~ 10

Author(s):

Kevin R. Math ◽

Helene Pavlov ◽

Edward DiCarlo ◽

Walther H. O. Bohne

Keyword(s):

Soft Tissue ◽

Soft Tissue Tumor ◽

Spindle Cell ◽

Soft Tissue Tumors ◽

Imaging Features ◽

Spindle Cell Lipoma ◽

Imaging Evaluation ◽

Presumptive Diagnosis ◽

Pleomorphic Lipoma ◽

Atypical Lipoma

Lipomas are among the most commonly encountered soft tissue tumors in clinical practice, though they are rare in the foot. Although a presumptive diagnosis is typically made clinically, those tumors with atypical clinical features may require radiological consultation. Difficulty arises when radiographic features are not typical of lipoma. We present a fatty soft tissue tumor of the foot with nonadipose elements on magnetic resonance imaging evaluation. Differentiation of lipoma variants (e.g., spindle cell lipoma, atypical lipoma, pleomorphic lipoma, lipoblastoma, angiolipoma) from liposarcoma based on imaging features is not possible, necessitating surgical resection for definitive histological diagnosis.

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