Key result
Fine-needle aspiration yields a benign diagnosis in ~92% of fibrous histiocytomas.
Why the study?
What are the cytopathological criteria for diagnosing benign fibrous histiocytoma using fine-needle aspiration?
Observational (n=36)
What are the cytopathological criteria for diagnosing benign fibrous histiocytoma using fine-needle aspiration?
Fine-needle aspiration of benign fibrous histiocytoma shows characteristic cytological features, though some cases may be misinterpreted as malignant.
Answers are grounded in this paper and cite their sources.
FNA of fibrous histiocytoma warrants interpretive caution to avoid malignancy misclassification; case reports leave cytological criteria open for prospective validation.
There is a limited number of correlative cytopathological studies of fibrous histiocytoma (FHC). To better define cytopathological criteria of diagnosis, we have reviewed fine-needle aspirates (FNA) from 36 FHCs (32 classical, 1 myxoid, and 3 aneurysmal variants on corresponding histological sections). Original cytological diagnoses were benign in 33 (91.7%) cases (22 accurate) and false positive in 3 (8.3%) cases. All smears were surprisingly homogenous and composed of histiocytic cells with finely vacuolated cytoplasm in 27 (75%) cases, small regular spindle cells in 25 (69%) cases, and giant cells in 17 (47%) cases. Histiocytic cells were attached to vascular structures in 9 (25%) cases. Slight cytonuclear atypia was seen in five (14%) cases. Three (8.3%) cases showed numerous siderophages. In two (5.6%) cases, there were abundant inflammatory backgrounds and in one (3%) case there was a scant myxoid background. Storiform patterns, round cells, prominent atypia, necroses, or mitotic figures were not seen. FHC should be differentiated from other benign, low- and intermediate-grade spindle-cell neoplasms such as low-grade fibrosarcoma, dermatofibrosarcoma protuberans, nodular fasciitis, spindle-cell malignant melanoma, and monophasic synovial sarcoma. Some cases may be misinterpreted as malignant, especially in cases of recurrence or in patients with a cancer history.
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Klijanienko et al. (2004) conducted an observational in Fibrous histiocytoma (n=36). Fine-needle aspiration (FNA) was evaluated on Original cytological diagnoses (benign). Fine-needle aspiration of 36 fibrous histiocytomas yielded a benign diagnosis in 91.7% of cases, with false positives for malignancy occurring in 8.3% of cases.
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