A diagnostic review of carcinomas and sarcomas of the mediastinum: making the diagnosis on fine-needle aspiration and core needle biopsy specimens

Smith, Alexander P.; Dueber, Julie C.; Allison, Derek B.

doi:10.1053/j.semdp.2020.04.007

Cited by 5 publications

(3 citation statements)

References 58 publications

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“…[2] However, some reports have described EBUS-TBNA, endoscopic ultrasound-guided fine-needle aspiration, and transthoracic biopsy for the diagnosis of schwannomas, and diagnosis based on these small specimens is consistent with that of surgical specimens. [2,[8][9][10][11][12]16,[23][24][25] When properly prepared, cell blocks obtained from EBUS-TBNA enable cytological examination and immunocytochemical staining, which can confirm the diagnosis of schwannomas. However, when spindle cells are encountered in small specimens (e.g., TBNA), it is difficult to make a definitive diagnosis based on cytological features in some cases because a broad differential diagnosis is needed.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration as a diagnostic modality for schwannoma: A case report

Liu

Chen

et al. 2022

Medicine

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Introduction: Schwannomas are the most common nerve sheath tumors in the paravertebral mediastinum. Although radiological imaging is helpful in diagnosing schwannomas, a definitive diagnosis is dependent on pathological features of a surgical specimen. For patients who require preoperative diagnosis, an incisional biopsy using minimally invasive surgery is preferred. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is less commonly used for suspected schwannomas. Patient concerns: A 48-year-old woman presented to the clinic with complaints of productive cough for >1 month, expectorating yellow and mucoid sputum approximately 4 to 5 times per day. Chest computed tomography revealed a well-circumscribed, homogeneous, soft tissue mass lesion in right upper posterior mediastinum, measuring 55 mm × 44 mm. Vocal fremitus in the right upper lung was diminished, the percussion note was slightly dull, and breath sounds were slightly reduced on auscultation. The patient was a nondrinker and nonsmoker, with no other relevant medical history. There was no significant relevant family medical history. Diagnosis: Complete blood count and blood biochemistry were within normal limits, except for an elevated erythrocyte sedimentation rate (32 mm/h). EBUS-TBNA was performed and histopathological findings were consistent with schwannoma. Interventions: The patient underwent schwannoma excision by thoracoscopy. Pathological findings from the surgical specimen were consistent with the EBUS-TBNA results. Based on EBUS-TBNA and postsurgical pathology, the patient was diagnosed with a right upper mediastinal schwannoma (Antoni B). Outcomes: The patient experienced an uneventful postoperative recovery with no adjuvant therapy and was discharged on April 18, 2017. The patient has been followed up for 4 years and has not experienced any symptoms. Conclusions: Cell blocks obtained from EBUS-TBNA afford the possibility of cytological examination and immunocytochemical staining, which can confirm diagnosis of schwannoma.

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Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided transbronchial needle aspiration as a diagnostic modality for schwannoma: A case report

Liu

Chen

et al. 2022

Medicine

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“…Adipose tissue with abundant cytoplasm, different-sized vacuoles, and small regular nuclei are present; however, one cytology report illustrated the lack of adipose tissue in their case, and another report illustrated that mild atypia within the adipose tissue led to the erroneous diagnosis of liposarcoma on FNA [79,80]. However, should atypically large nuclei be observed within or next to vacuolated fat cells on FNA smears, the possibility of a well-differentiated liposarcoma cannot be excluded [81]. In these cases, cell block preparation with MDM2 and CDK4 immunohistochemistry can be used to assess for positive nuclear staining, along with FISH studies for amplification of MDM2 for WDLPS (negative in thymolipoma or lipoma) [31].…”

Section: Lipomatous Tumorsmentioning

confidence: 93%

The Utility of Fine Needle Aspiration (FNA) Biopsy in the Diagnosis of Mediastinal Lesions

et al. 2023

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Fine needle aspiration is a minimally invasive, low-morbidity, and cost-efficient technique for the sampling of mediastinal lesions. Additionally, ancillary testing on FNA samples can be used for the refinement of diagnoses and for treatment-related purposes (flow cytometry, cytogenetics, immunohistochemistry, and molecular diagnostics). Mediastinal lesions, however, can show a variety of lineages and morphologic features, giving rise to diagnostic dilemmas. As a result, the differential diagnosis can vary widely and becomes especially challenging due to the smaller sample size on FNA and the variability in component sampling. For appropriate patient management and to determine the correct treatment strategies, accurate pathologic diagnoses are paramount. In this review, we present the cytomorphologic features together with the immunophenotypic findings of mediastinal lesions, with emphasis on the diagnostic challenges and pitfalls in FNA cytology samples, including smears and cell block sections.

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“…The acquisition of sarcoma tissue samples for organoid generation depends on various factors, including tumor location, size, accessibility, and patient-specific considerations. Common approaches for obtaining sarcoma tissue samples include tumor biopsy, surgical resection, fine needle aspiration (FNA), core needle biopsy, and explant culture [27,28]. Once the tissue samples are collected, it is essential to promptly transport them to the laboratory under appropriate conditions to effectively preserve the tumor samples.…”

Section: Approaches For Obtaining Sarcoma Tissue Samplesmentioning

confidence: 99%

Patient-Derived Organoids as a Promising Tool for Multimodal Management of Sarcomas

Xu,

Tan,

Guo

2023

Cancers

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The management of sarcomas, a diverse group of cancers arising from connective tissues, presents significant challenges due to their heterogeneity and limited treatment options. Patient-derived sarcoma organoids (PDSOs) have emerged as a promising tool in the multimodal management of sarcomas, offering unprecedented opportunities for personalized medicine and improved treatment strategies. This review aims to explore the potential of PDSOs as a promising tool for multimodal management of sarcomas. We discuss the establishment and characterization of PDSOs, which realistically recapitulate the complexity and heterogeneity of the original tumor, providing a platform for genetic and molecular fidelity, histological resemblance, and functional characterization. Additionally, we discuss the applications of PDSOs in pathological and genetic evaluation, treatment screening and development, and personalized multimodal management. One significant advancement of PDSOs lies in their ability to guide personalized treatment decisions, enabling clinicians to assess the response and efficacy of different therapies in a patient-specific manner. Through continued research and development, PDSOs hold the potential to revolutionize sarcoma management and drive advancements in personalized medicine, biomarker discovery, preclinical modeling, and therapy optimization. The integration of PDSOs into clinical practice can ultimately improve patient outcomes and significantly impact the field of sarcoma treatment.

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A diagnostic review of carcinomas and sarcomas of the mediastinum: making the diagnosis on fine-needle aspiration and core needle biopsy specimens

Cited by 5 publications

References 58 publications

Endobronchial ultrasound-guided transbronchial needle aspiration as a diagnostic modality for schwannoma: A case report

Endobronchial ultrasound-guided transbronchial needle aspiration as a diagnostic modality for schwannoma: A case report

The Utility of Fine Needle Aspiration (FNA) Biopsy in the Diagnosis of Mediastinal Lesions

Patient-Derived Organoids as a Promising Tool for Multimodal Management of Sarcomas

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