FNA Cytology of Soft Tissue and Bone Tumors

H.A. Domanski, C.S. Walther

Description

Fine-needle aspiration cytology (FNAC) has been commonly used to follow up on previously treated sarcomas or to confirm soft tissue and bone metastases of carcinomas, melanomas or lymphomas. Its role as the first-line approach in the diagnosis of primary soft tissue and bone tumors has increased due to progress of less invasive diagnostic procedures and the growing availability of diagnostic ancillary tests. This comprehensive and richly-illustrated volume presents cytomorphology of all common neoplastic soft tissue and bone lesions but also of rare tumors largely described in case reports. Key points for cytological features, differential diagnosis, and the use of ancillary tests are discussed and illustrated in order to facilitate the diagnostic work-up in FNA samples. The volume is organized on the basis of the most recent WHO classification used in surgical pathology in order to provide a practical guide for modern cytologic diagnosis of surgical soft tissue and bone pathology. It is aimed mainly at surgical pathologists and cytopathologists, but also at orthopedic surgeons and clinical oncologists.

Informations

• Publié par: S. Karger AG
• Date de parution: 27 juillet 2017
• Nombre de lectures: 0
• EAN13: 9783318060775
• Langue: English
• Poids de l'ouvrage: 9 Mo

Extrait

FNA Cytology of Soft Tissue and Bone Tumors
Monographs in Clinical Cytology
Vol. 22
Series Editor
Philippe Vielh Dudelange, Luxembourg
 
Henryk A. Domanski Lund
Charles S. Walther Lund
FNA Cytology of Soft Tissue and Bone Tumors
109 figures, 108 in color, and 8 tables, 2017
Monographs in Clinical Cytology
Founded 1965 by Georg L. Wied, Chicago, IL
_______________________ Dr. Henryk A. Domanski Department of Pathology Skåne University Hospital SE–221 85 Lund (Sweden)
_______________________ Dr. Charles S. Walther Department of Pathology Skåne University Hospital SE–221 85 Lund (Sweden)
Library of Congress Cataloging-in-Publication Data
Names: Domanski, Henryk A., author. | Walther, Charles S., author.
Title: FNA cytology of soft tissue and bone tumors / Henryk A. Domanski, Charles S. Walther.
Other titles: Monographs in clinical cytology ; v. 22. 0077–0809
Description: Basel ; New York : Karger, 2017. | Series: Monographs in clinical cytology ; vol. 22 | Includes bibliographical references and index.
Identifiers: LCCN 2017025751| ISBN 9783318060768 (hard cover : alk. paper) | ISBN 9783318060775 (elSBN)
Subjects: | MESH: Soft Tissue Neoplasms-pathology | Bone Neoplasms--pathology | Biopsy, Fine-Needle
Classification: LCC RC280.B6 | NLM QZ 340 | DDC 616.99/47107--dc23 LC record available at https://lccn.loc.gov/2017025751
 
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© Copyright 2017 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed on acid-free and non-aging paper (ISO 9706)
ISSN 0077–0809
ISBN 978–3–8055–06076–8
e-ISBN 978–3–8055–06077–5
 
Contents
Preface
Domanski, H.A.; Walther, C.S. (Lund)
Chapter 1
Principles in the Examination and Management of Soft Tissue Lesions
Chapter 2
Sampling and Preparation Techniques
Chapter 3
Ancillary Techniques
Chapter 4
Normal Elements and the Cytologic Features of Reactive Changes in Soft Tissue
Chapter 5
Adipocytic Tumors
Chapter 6
Fibroblastic/MyofibroblasticTumors
Chapter 7
So-Called Fibrohistiocytic Tumors
Chapter 8
Smooth-Muscle Tumors
Chapter 9
Pericytic (Perivascular) Tumors
Chapter 10
Skeletal-Muscle Tumors
Chapter 11
Vascular Tumors
Chapter 12
Gastrointestinal Stromal Tumor
Chapter 13
Nerve Sheath Tumors
Chapter 14
Tumors of Uncertain Differentiation
Chapter 15
Undifferentiated/Unclassified Sarcomas
Chapter 16
Neuroectodermal Tumors
Chapter 17
Principles in the Examination and Management of Bone Neoplasms; Normal Elements and the Cytologic Features of Reactive Changes in the Bone
Chapter 18
Osteogenic Tumors
Chapter 19
Cartilaginous Tumors
Chapter 20
Ewing Sarcoma
Chapter 21
Giant Cell Tumor of Bone and Other Giant Cell-Rich Lesions
Chapter 22
Notochordal Tumors
Chapter 23
Lymphohematopoietic and Histiocytic Tumors
Chapter 24
Bone Metastases
Chapter 25
Bone Lesions Rarely Examined by Fine-Needle Aspiration
Subject Index
 
Preface
An increasing use of minimally invasive diagnostic procedures together with continuously growing ancillary techniques applied to cytological specimens brought widespread acceptance of using fine-needle aspiration cytology (FNAC) in the diagnosis of soft tissue and bone lesions. While cytological examinations have been used in many centers to follow up on previously treated sarcomas or to confirm soft tissue and bone metastases, in the last decade the primary diagnosis of soft tissue and bone tumors has emerged as an important new target for FNAC. As the first-line approach, cytologic examination most often provides diagnostic information allowing the initiation of treatment or guidance of the continued diagnostic investigation.
The purpose of this volume is to describe, illustrate, and summarize the cytological criteria of the most common entities of musculoskeletal tumors and those rare tumors where cytological features have been largely described in case reports and in smaller series. Correlations between cytology and the diagnostic use of ancillary techniques applicable to FNAC, such as immunocytochemical and molecular tests, are detailed on an entity-by-entity basis in order to facilitate the diagnostic workup in the cytological samples. The selection of entities illustrated are based on experience with patients referred to the Sarcoma Centre of the Skane University Hospital and the illustrations are taken from the considerable cytological material of musculoskeletal lesions, gathered over more than 45 years, which is available in the archives of our institution.
This book provides a comprehensive and well-illustrated review of the FNAC of soft tissue and bone tumors that can be used in the everyday practice of pathologists and cytopathologists in the musculoskeletal field. The content will also be of interest to residents and fellows in cytology, as well as orthopedic surgeons, clinical oncologists, and anyone involved in the diagnosis and therapy of patients with soft tissue and bone lesions.
Acknowledgements
I would like to thank Dr. Måns Åkerman, the pioneer of musculoskeletal cytopathology and former Head of the Department of Pathology at the Lund University Hospital – thanks for teaching and inspiring me to pursue soft tissue and bone pathology/cytopathology.
Henryk A. Domanski , Lund
I would like to thank Dr. Fredrik Mertens for his guidance and help with tumor genetics.
Charles S. Walther , Lund
We would like to thank Dr. Philippe Vielh and Mr. Thomas Nold for recognizing the need for this monograph, and the editorial staff of Karger, particularly Ms. Rebecca Ganz and Mr. Ruedi Jappert, for their excellent administrative assistance during our work on this volume.
Henryk A. Domanski and Charles S. Walther , Lund
Chapter 1
Domanski HA, Walther CS: FNA Cytology of Soft Tissue and Bone Tumors. Monogr Clin Cytol. Basel, Karger, 2017, vol 22, pp 1–12 (DOI: 10.1159/000475088)
___________________
Principles in the Examination and Management of Soft Tissue Lesions
Clinical Features and Team Work
Soft tissue neoplasms comprise a heterogeneous group of lesions with mesenchymal differentiation. Sarcomas are rare, constituting less than 1% of all malignant neoplasms. Benign soft tissue tumors are estimated to be approximately 100 times more frequent than sarcomas. Soft tissue tumors may occur in different planes and locations. However, 99% of benign soft tissue tumors are superficial while two-thirds of the extremity and trunk-wall sarcomas are deep seated. Age-specific incidence rates clearly demonstrate that soft tissue sarcomas are more common with increasing age. There is a slight male predominance, but the gender- as well as age-related incidence is also related to the histologic type and subtype of sarcomas.
In the course of the diagnostic workup of soft tissue masses, a biopsy is necessary in most cases to confirm malignancy and in the case of sarcoma to assess the grade of malignancy and the histologic type. The difficulties in diagnosing patients with musculoskeletal tumors stem mainly from their rarity and to the lack of experience with the microscopic appearance of soft tissue lesions on the part of most pathologists not working in orthopedic-oncology centers [ 1 , 2 ].
The best approach to a successful diagnostic evaluation of musculoskeletal lesions is to combine clinical data and radiographic findings with the morphologic interpretation of cells and tissue, complemented by ancillary techniques. In specialized orthopedic-oncology centers, orthopedic-surgical, oncologic, radiologic, pathologic/cytologic, and molecular biologic expertise can be combined in a multidisciplinary team to allow the adequate evaluation and therapy, as well as follow-up, of patients with