Fine-needle aspiration of synovial sarcoma reveals a typical cytologic pattern, but electron microscopic and molecular genetic analyses are necessary diagnostic adjuncts to avoid pitfalls.
Observational (n=37)
Yes
What are the cytologic criteria for diagnosing synovial sarcoma using fine-needle aspiration?
Fine-needle aspiration can diagnose synovial sarcoma when the yield is rich, but ancillary diagnostics like electron microscopy or molecular genetics are necessary to avoid diagnostic pitfalls.
The cytologic criteria of synovial sarcoma in fine-needle aspirates were defined by a retrospective examination of 37 primary tumors. Irrespective of subtype, a typical pattern at low power was found, provided the yield was rich. The typical pattern was a mixture of dispersed cells with the presence of striped nuclei and cell-tight tumor tissue fragments with irregular borders. Often a branching network of vessels was present in the fragments, imitating a true vascular tumor. Except in poorly differentiated synovial sarcomas, the tumor cells were, small to medium in size, with rounded, ovoid, or fusiform bland nuclei with inconspicuous nucleoli. In the biphasic variant, small glandular- or acinar-like structures were present, although not in all cases. In the poorly differentiated type, however, the cellular pleomorphism was marked with the presence of cells with irregular nuclei and rhabdomyoblast-like cells, corresponding to the pleomorphic variant. The Ewing's sarcoma-like and the atypical spindle cell variants of poorly differentiated synovial sarcoma were not diagnosed in the material. An unequivocal diagnosis of sarcoma is possible when the yield is rich. However, ancillary diagnostics are necessary for a correct diagnosis, to avoid important pitfalls, such as other sarcomas with bland tumor cells and vessel-rich tumor fragments, in particular, solitary fibrous tumor and true hemangiopericytoma. Electron microscopic and/or molecular genetic analyses were better diagnostic adjuncts than immunocytochemistry.
Åkerman et al. (Thu,) conducted a observational in Synovial sarcoma (n=37). Fine-needle aspiration and ancillary diagnostics was evaluated on Cytologic criteria for diagnosis of synovial sarcoma. Fine-needle aspiration of synovial sarcoma reveals a typical cytologic pattern, but electron microscopic and molecular genetic analyses are necessary diagnostic adjuncts to avoid pitfalls.