Cytological Features of Spindle Cell Lesions of Head and Neck and Review of the Literature

Introduction: Spindle cell lesions in the head and neck often mimic sarcomas but may include a wide range of benign and malignant entities. Fine needle aspiration (FNA) is a minimally invasive method used to evaluate such lesions, though cytological interpretation can be challenging due to overlapping features. Methods: This retrospective study included 12 primary spindle cell lesions of the head and neck, selected based on inclusion/exclusion criteria. Papanicolaou and May-Grünwald-Giemsa stains were used for smear evaluation. Cell blocks were prepared, and cytological diagnoses were compared with histopathological outcomes. Results: The 12 cases were diagnosed as follows: nodular fasciitis (n=2), schwannoma (n=2), malignant peripheral nerve sheath tumor (n=1), leiomyosarcoma (n=1), liposarcoma (n=1), rhabdomyosarcoma (n=1), osteosarcoma (n=3), and chondroblastoma (n=1). Cytological features showed moderate correlation with final histology. Conclusion: FNA is a valuable, cost-effective tool for evaluating spindle cell lesions in the head and neck. While morphological overlap poses diagnostic limitations, ancillary techniques and molecular studies enhance its accuracy and clinical utility.