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Macau Periodical Index (澳門期刊論文索引)
- Author
- Wong, Nim Lai
- Title
- Fine needle aspiration cytology of pseudosarcomatous reactive proliferative lesions of soft tissue
- Journal Name
- 鏡湖醫學
- Pub. Info
- May. 2002, 總第15期, Vol.2, No.1, pp. 4-8
- Keyword
- Pseudosarcoma；nodular fasciitis；proliferative myositis；FNAC
- Abstract
- Abstract : Objective: Nodular fasciitis(NF), proliferative fasciitis(PF) and proliferative myositis(PM) are the most commn pseudosarcomatous reactive proliferative lesions lesions of soft tissue. These lesions often resolve spontaneously. The aims of this study were to summarize the diagnostic features of fine needle aspiration cytology(FNAC) of pseudosarcomatous reactive proliferative lesions of soft tissue and to establish the criteria in differentiating these lesions from true sarcoma, thus allowing conservative management. Methods: FNAC of 17 cases (13 NF, 2 PF, 2PM), from 1994 to 2001, were reviewed in corrlation with the clinical course or results of biopsy. Results: The FNAC features of pseudosarcomatous reactive proliferative sofe tissue lesions were charaterized by a pleomorphic pattern of the proliferative cells and the presence of ganglion-cell-like cells, The proliferative cells varied widely from spindle shaped with long cytoplasmic processes to more plump cells with round to oval nuclei. In spite of the large nuclei and prominent nucleoli in ganglion-cell-like cells, the nuclei were cytologically benign with thin and smooth nuclear membranes and fine chromatin. Clinically, all lesions appeares as small, superficially located, rapidly growing nodules with short duration of symptoms. Ten cases of NF, one case of PF and two cases of PM showed spontaneous resolution in 1-12 weeks (mean 4.7 weeks) following diagnosis by FNAC. All patients were clinically well and devoid of any symptoms or signs of recurrence or metastasis in a follow-up period of 1-64 months after FNAC or biopsies. Conclusion: It is possible to differentiate pseudosarcomatous reactive proliferative sofe tissue lesions from true sarcoma based on cytoligical criteria in FNAC together with clinical correlation. All such lesions diagnosed by FNAC should be managed non-surgically first, with follow-up. If regression does not occur within 4 to 8 weeks, surgery should then be performed. Paragraph Headings: 1. Materials and methods 2. Result 2.1. Clinical information 2.2. Cytologic features 2.2.1. Nodular fasciitis(13 cases) 2.2.2. Proliferative myositis (case 4 and 12 ) 2.2.3. Proliferative myositis (Case 7 and 16 ) 3. Discussion Tables: 1. Clinical information of 17 cases of pseudosarcomatous reactive proliferative lesions of soft tissue Figures: 1. Nodular fasciitis (Case 2). A-C. Aspirate: (A) Low power showed hypercellularity with numerous isolated cells and myxiod background (HE, x100); (B, C) Dispersed fibroblast cells varying widely in size and shape with some large ganglion-cell-like cell (HE, x400); (D) Biopsy findings (HE, x200) 2. Nodular fasciitis with spontaneous resolution (Case 14). The lesion was 2cm nodule in the R. forearm present for 4 days. Spontaneous resolution happened in two weeks after FNAB. (A) Hypercellularity with numerous isolated cells in a myxoid background (HE, x100); (B) The cells vary widely in size and shape with two multinucleated giant cells (HE, x200). (C, D) Ganglion-cell-like cells (HE, x400). 3. Proliferative fasciitis (Case 4). A-D. Aspirate: (A) Spondle cells within a background of collagenous material (HE, x200). (B)Cluster of collagenous material (HE, x200). (B)Cluster of ganglion-cells-like cells (HE, x400.) (C, D) Giant ganglion-cell-like cells (HE, x400). (E) Biopsy fndings (HE, x400). 4. Proliferative fasciitis with spontaneous resolution (Case 12). The leison was a 1.5cm neck nodule present for 10 days. Spontaneous resolution occurred in two weeks after FNAB. (A) The aspirate showed moderate cellularity, composed of numerous isolated cells and a few sheets of closely packed spindle cells. (HE, x100). (B) Abundant ganglion-cell-like cells (HE, x200). (C-F) Ganglion-cell-like cells of different size and shape (HE, x400). 5. Proliferative myositis with spontaneous resolution (Case 16). The lesion was a raised nodule, 4cm in diameter presen in the R. arm for 4 days. The nodule resolved in about 3 weeks after FNAB and phydionherapy. (A, B) The proliferative cells were situated within muscle tissue (A. HE, x100, B. HE, X200). (C-F)different size and shape (HE, x400).