scholarly journals CYTO HISTOLOGIC CORRELATION OF A LOW GRADE FIBROMYXOID SARCOMAAT AN UNUSUAL LOCATION – A CASE REPORT

2021 ◽  
pp. 1-3
Author(s):  
Pooja Jain ◽  
Annu Nanda ◽  
Deepak Kumar Singh ◽  
Udita Singhal
Keyword(s):  
Soft Tissues ◽  
Correct Diagnosis ◽  
Subcutaneous Fat ◽  
Needle Aspiration ◽  
Low Grade ◽  
Difficult Case ◽  
Nuclear Pleomorphism ◽  
Rare Tumour ◽  
Spindle Cells ◽  
High Local Recurrence Rate

BACKGROUND Low grade fibromyxoid sarcoma (LGFMS) is a rare tumour of the deep soft tissues seen in young adults. The histologic features of LGFMS are well established, however the cytologic findings are scantily defined and the distinction from other benign and malignant myxoid soft tissue tumours is difficult. CASE DETAILS A 29 year old male presented with a superficial swelling in the left areolar region for two months. USG revealed a well-defined 2 by 2 cm hyperechoic lesion extending upto the subcutaneous fat. FNA yielded mucoid material and smears showed spindle cells having round to elongated nuclei with mild anisokaryosis, bland chromatin and wispy cytoplasm in a myxoid background. No significant nuclear pleomorphism or mitoses were noted. A diagnosis of myxoid mesenchymal lesion was made. The excised tumour was well circumscribed with grey white cut surface showing myxoid areas. Microscopically, the tumour displayed moderate cellularity with storiform, intersecting and parallel bundles of spindle cells showing mild nuclear pleomorphism. The myxoid areas showed cells in a haphazard fashion floating in abundant mucoid matrix associated with a capillary network. The mitotic index was low. IHC showed tumor cells positive for vimentin and negative for S-100 & SMA. CONCLUSION LGFMS is a rare low-grade malignancy with a high local recurrence rate and late metastasis. The diagnosis of LGFMS can be difficult to render from fine needle aspiration cytology (FNAC) alone because of morphological overlap with other spindle cell and myxoid lesions. Cytohistological correlation and IHC is helpful in arriving at a correct diagnosis.

Carcinoma cuniculatum of the larynx: a rare clinicopathological entity

2007 ◽  
Vol 122 (10) ◽  
pp. 1118-1123 ◽  
Author(s):  
R Puxeddu ◽  
D Cocco ◽  
G Parodo ◽  
G Mallarini ◽  
M Medda ◽  
...  
Keyword(s):  
World Literature ◽  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Low Grade ◽  
Upper Aerodigestive Tract ◽  
Supracricoid Laryngectomy ◽  
Rare Tumour ◽  
The World ◽  
Close Cooperation ◽  
Carcinoma Cuniculatum

AbstractObjective:Carcinoma cuniculatum is a rare variant of low-grade squamous cell carcinoma. We report the second case of carcinoma cuniculatum of the larynx in the literature.Method:Case report and review of the world literature concerning carcinoma cuniculatum of the larynx and upper aerodigestive tract.Results:A histologically proven carcinoma cuniculatum of the larynx is reported in a 72-year-old man. The patient underwent a supracricoid laryngectomy with crico-hyoidopexy, and was free of disease at 70 months after surgery. We emphasise the clinical presentation, histology and therapeutic approach of this rare tumour.Conclusion:To our knowledge this is the second report in the world literature of carcinoma cuniculatum of the larynx. Carcinoma cuniculatum of the larynx must be considered as a distinct ‘clinicopathological entity’ and close cooperation between the clinician and the pathologist is essential for the correct diagnosis of these tumour as regards to the correct classification and therapy.

scholarly journals Reactive Lesions of Oro-Maxillofacial Region

2021 ◽  
pp. 599-614
Author(s):  
Raja Sekhar Gali
Keyword(s):  
Soft Tissues ◽  
Correct Diagnosis ◽  
Low Grade ◽  
Maxillofacial Region ◽  
Diagnostic Dilemma ◽  
Hormonal Influence ◽  
Facial Region ◽  
Appropriate Treatment ◽  
The Common ◽  
Low Grade Inflammation

AbstractA plethora of pathologies occurs in the skeletal and soft tissues of the oro-facial region that are reactive. These arise as a result of chronic low-grade inflammation, trauma, hormonal influence and other causes. Varied types of clinical, radiological and histological presentations are often associated with these lesions that pose a diagnostic dilemma to the clinician. This chapter describes in detail the common reactive lesions of the maxillofacial region with an emphasis on correlating the clinical and investigational findings to arrive at the correct diagnosis and provide appropriate treatment.

Magnetic Resonance Evaluation of Disease of the Soft Tissues in Children

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 696-701
Author(s):  
Mervyn D. Cohen ◽  
G. Paul DeRosa ◽  
Martin Kleiman ◽  
Murray Passo ◽  
David A. Cory ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Correct Diagnosis ◽  
Subcutaneous Fat ◽  
Magnetic Resonance Images ◽  
Careful Attention ◽  
Resonance Imaging ◽  
Adjacent Structures ◽  
Definition Of

Magnetic resonance imaging was a sensitive modality for identifying pathology in the soft tissues of 32 children, and it consistently showed more abnormality than CT. Magnetic resonance images are not histology specific, but with careful attention to the location of the abnormality, to the definition of the margins, and to the evaluation of involvement of adjacent muscle, bone, subcutaneous fat, and skin, the correct diagnosis can be strongly predicted in most cases. The ability of magnetic resonance to image in multiple planes aids in the evaluation of the extent of lesions and their relationship to adjacent structures. With magnetic resonance imaging, one can accurately predict the extent of abnormality, and there is great potential for the study of disease of soft tissues.

Rare Fibroblastic and Myofibroblastic Tumors

2017 ◽  
Author(s):  
Vasilena Zheleva ◽  
Yu Liang ◽  
Laleh Melstrom
Keyword(s):  
Young Adults ◽  
Local Recurrence ◽  
Soft Tissues ◽  
Distant Metastases ◽  
Low Grade ◽  
Linear Arrangement ◽  
Myxoid Stroma ◽  
High Local Recurrence Rate ◽  
Inflammatory Myofibroblastic Tumors ◽  
Hands And Feet

This review discusses the clinical presentation, histopathologic characteristics, and diagnostic and treatment algorithms for several distinct fibroblastic and myofibroblastic tumor subtypes. Low-grade fibromyxoid sarcomas typically arise in the deep soft tissues of the proximal extremities or trunk in young adults. They tend to have a high local recurrence rate, although some may have distant metastases. Histologically, they consist of bland fibroblasts with a whorled or linear arrangement alternating with hypocellular myxoid stroma. Sclerosing epithelioid fibrosarcomas typically arise in the deep soft tissues of the lower extremities of middle-aged adults. They tend to be slow growing but clinically aggressive, with a high propensity for local recurrence and distant metastases. Classic histologic features include the presence of small, uniform, ovoid epithelioid cells with sparse cytoplasm, arranged in cords within a sclerotic fibrous stroma. Myxoinflammatory fibroblastic sarcomas mainly affect the hands and feet. They are prone to local recurrence, with a very low likelihood of distant metastasis. Histologically, they have nodular architecture and highly cellular areas with an abundance of inflammatory cells, among which characteristic large Reed-Sternberg–like and lipoblast-like cells and hypocellular areas rich in myxoid stroma can be seen. Inflammatory myofibroblastic tumors typically occur in children and young adults, with common anatomic locations being the omentum, mesentery, retroperitoneum, and lung. Histologically, they are composed of myofibroblastic spindle cells accompanied by a lymphoplasmacytic inflammatory infiltrate. Surgical resection is the mainstay of treatment for all of the above tumor types. Radiation therapy may be used as adjuvant therapy for tumors with a high risk of local recurrence, in the setting of positive margins, or for unresectable primary or metastatic disease. There is no definite role for standard chemotherapy, but in certain cases, targeted therapy may be of use, such as ALK inhibitors in ALK-positive inflammatory myofibroblastic tumors.  This review contains 16 figures, 1 table and 30 references Key words: inflammatory myofibroblastic sarcoma, low-grade fibromyxoid sarcoma, myxoinflammatory fibroblastic sarcoma, sclerosing epithelioid fibrosarcoma

scholarly journals Myofibroblastic sarcoma of the bone: two cases

2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Esperanza moreno ◽  
Eduardo Ortiz-Cruz ◽  
José Juan Pozo-Kreilinger ◽  
Manuel Peleteiro-Pensado
Keyword(s):  
Head And Neck ◽  
Soft Tissues ◽  
Treatment Options ◽  
Bone Sarcoma ◽  
Initial Diagnosis ◽  
Low Grade ◽  
Histological Findings ◽  
Rare Tumour ◽  
Myofibroblastic Sarcoma

Low-grade myofibroblastic sarcoma (L-G MFS) is a rare tumour that commonly affects the soft tissues of the head and neck. Its location in bone is very rare and there are few cases published in the literature, which sometimes leads to a wrong initial diagnosis. The following report will give an overview of the clinical, radiological and histological findings in two patients with a very unusual bone sarcoma, which are more often found in the soft tissues. Treatment options and outcome will be discussed.

Rare Fibroblastic and Myofibroblastic Tumors

2017 ◽  
Author(s):  
Vasilena Zheleva ◽  
Yu Liang ◽  
Laleh Melstrom
Keyword(s):  
Young Adults ◽  
Local Recurrence ◽  
Soft Tissues ◽  
Distant Metastases ◽  
Low Grade ◽  
Linear Arrangement ◽  
Myxoid Stroma ◽  
High Local Recurrence Rate ◽  
Inflammatory Myofibroblastic Tumors ◽  
Hands And Feet

This review discusses the clinical presentation, histopathologic characteristics, and diagnostic and treatment algorithms for several distinct fibroblastic and myofibroblastic tumor subtypes. Low-grade fibromyxoid sarcomas typically arise in the deep soft tissues of the proximal extremities or trunk in young adults. They tend to have a high local recurrence rate, although some may have distant metastases. Histologically, they consist of bland fibroblasts with a whorled or linear arrangement alternating with hypocellular myxoid stroma. Sclerosing epithelioid fibrosarcomas typically arise in the deep soft tissues of the lower extremities of middle-aged adults. They tend to be slow growing but clinically aggressive, with a high propensity for local recurrence and distant metastases. Classic histologic features include the presence of small, uniform, ovoid epithelioid cells with sparse cytoplasm, arranged in cords within a sclerotic fibrous stroma. Myxoinflammatory fibroblastic sarcomas mainly affect the hands and feet. They are prone to local recurrence, with a very low likelihood of distant metastasis. Histologically, they have nodular architecture and highly cellular areas with an abundance of inflammatory cells, among which characteristic large Reed-Sternberg–like and lipoblast-like cells and hypocellular areas rich in myxoid stroma can be seen. Inflammatory myofibroblastic tumors typically occur in children and young adults, with common anatomic locations being the omentum, mesentery, retroperitoneum, and lung. Histologically, they are composed of myofibroblastic spindle cells accompanied by a lymphoplasmacytic inflammatory infiltrate. Surgical resection is the mainstay of treatment for all of the above tumor types. Radiation therapy may be used as adjuvant therapy for tumors with a high risk of local recurrence, in the setting of positive margins, or for unresectable primary or metastatic disease. There is no definite role for standard chemotherapy, but in certain cases, targeted therapy may be of use, such as ALK inhibitors in ALK-positive inflammatory myofibroblastic tumors.  Key words: inflammatory myofibroblastic sarcoma, low-grade fibromyxoid sarcoma, myxoinflammatory fibroblastic sarcoma, sclerosing epithelioid fibrosarcoma

scholarly journals Rare presentation of ectopic thymoma

2021 ◽  
Vol 8 (9) ◽  
pp. 2838
Author(s):  
Aisha Nehla ◽  
Deepalakshmi Tanthry ◽  
Chethana R. ◽  
Mahesh Santhraya G. ◽  
Devan P. P. ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Needle Aspiration ◽  
Anterior Mediastinum ◽  
Low Grade ◽  
Aspiration Cytology ◽  
Rare Presentation ◽  
Rare Tumour ◽  
Ectopic Tissue ◽  
Needle Aspiration Cytology ◽  
Thyroid Malignancies

Thymoma is the most common tumor of the anterior mediastinum with an incidence of 0.15 cases per 100,000. Ninety percent of all thymoma occur in the anterior mediastinum, with the remainder occurring in the neck or other mediastinal areas. Ectopic cervical thymoma (ECT) is an extremely rare tumor that originates from ectopic tissue and is caused by the aberrant migration of the embryonic thymus. ECTs are often confused with thyroid or parathyroid swellings due to their anatomical positioning. Intrathyroid epithelial thymoma is a rare tumour comprising about 0.08% of all primary thyroid malignancies. It is low-grade thyroid carcinoma with squamous cell differentiation whose overall survival rate was found to be 71%. Here we presented a case of 43 year old female, came with swelling in front of the neck since many years. Ultrasound neck and fine needle aspiration cytology (FNAC) was performed. Patient underwent total thyroidectomy and specimen obtained was sent for histopathological examination. It revealed ectopic intrathyroid thymoma.

scholarly journals Deep sedation versus minimal sedation during endobronchial ultrasound transbronchial needle aspiration

2018 ◽  
Vol 88 (3) ◽  
Author(s):  
Sergio C. Conte ◽  
Giulia Spagnol ◽  
Marco Confalonieri ◽  
Beatrice Brizi
Keyword(s):  
Diagnostic Accuracy ◽  
Deep Sedation ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Multicenter Studies ◽  
Transbronchial Needle Aspiration ◽  
Patient Tolerance ◽  
Procedural Time ◽  
Comparable Accuracy

The sedation plays an important role in the endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) procedure. The sedation can be Minimal (anxiolysis), Moderate (conscious sedation) or Deep. The ACCP guidelines suggest that moderate or deep sedation (DS) is an acceptable approach. In fact, several studies compare moderate versus deep sedation, but no study has been carried out to compare deep sedation versus minimal. We carried out a retrospective study to compare the Deep versus Minimal sedation (MiS) in patients undergoing EBUS-TBNA.  The primary end point was the diagnostic accuracy. The secondary end points were adequacy and sensitivity. We evaluated the LN size sampling, procedural time, complications and patient tolerance. Thirty-six patients underwent EBUS-TBNA, 16 under DS and 20 under MiS. The overall diagnostic accuracy for correct diagnosis was 92.9% in DS group and 94.1% in MiS group (p=0.554). Sample adequacy, defined as the percentage of patients with a specific diagnosis by EBUS-TBNA, was 87.5% (14 of 16) and 85% (17 of 20) for the DS group and MiS group, respectively, (p=0.788); the sensitivity was 92.9% in the DS group (95% CI, 73-100%) and 92.9% in the MiS group (95% CI, 77-100%) (p=0.463). There were no major complications in either group. Minor complications were 4 in MiS and 1 in DS (p=0.355).  The patients in the MiS group recalled the procedure more often compared to the other group (p=0.041). The majority of the patients would agree to undergo the same procedure again in the future in both groups (p=0.766).  In our experience EBUS-TBNA performed under MiS has comparable accuracy, adequacy, sensitivity, complications and patient satisfaction to DS, even if the sample was small.  Future prospective multicenter studies are needed to confirm our results.

Pitfalls in Salivary Gland Fine-Needle Aspiration Cytology: Lessons From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

2005 ◽  
Vol 129 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Jonathan H. Hughes ◽  
Emily E. Volk ◽  
David C. Wilbur
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Interlaboratory Comparison ◽  
False Negative ◽  
Diagnostic Errors ◽  
Poor Performance ◽  
Needle Aspiration ◽  
Low Grade ◽  
Fine Needle

Abstract Context.—We use data from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology to identify common diagnostic errors in salivary gland fine-needle aspiration (FNA). Objective.—To identify salivary gland FNA cases with poor performance characteristics in the Nongynecologic Cytology Program surveys, so that the most common diagnostic pitfalls can be avoided. Design.—A retrospective review of the College of American Pathologists Nongynecologic Cytology Program's cumulative data from 1999 to 2003 revealed the most common false-positive and false-negative interpretations on FNA for common salivary gland lesions. Slides that performed poorly were then reviewed to identify the cytologic characteristics that may have contributed to their poor performance. Results.—A total of 6249 participant responses with general interpretations of benign (n = 4642) or malignant (n= 1607) were reviewed. The sensitivity and specificity of the participant responses for correctly interpreting the cases as benign or malignant were 73% and 91%, respectively. Benign cases with the highest false-positive rates were monomorphic adenoma (53% false-positive), intraparotid lymph node (36%), oncocytoma (18%), and granulomatous sialadenitis (10%). Malignant cases with the highest false-negative rates were lymphoma (57%), acinic cell carcinoma (49%), low-grade mucoepidermoid carcinoma (43%), and adenoid cystic carcinoma (33%). Selected review of the most discordant individual cases revealed possible explanations for some of the interpretative errors. Conclusions.—These data confirm the difficulty associated with interpretation of salivary gland FNA specimens. Cytologists should be aware of the potential false-positive and false-negative interpretations that can occur in FNAs from this organ site in order to minimize the possibility of diagnostic errors.

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