Cytopathology of myxofibrosarcoma: a study of 66 cases and literature review

Wakely, Paul E.

doi:10.1016/j.jasc.2020.09.004

Cited by 15 publications

(14 citation statements)

References 26 publications

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“…Pseudolipoblasts owing to the accumulation of intracytoplasmic myxoid material in tumor cells can be seen. 32 IHC and molecular testing have a limited role in confirming the diagnosis of myxofibrosarcoma.…”

Section: Myxofibrosarcomamentioning

confidence: 99%

Approach to FNA of Myxoid Soft Tissue Tumors

Satturwar

Wakely

Pantanowitz

2022

Advances in Anatomic Pathology

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Myxoid tumors of the soft tissue encompass a group of heterogenous tumors that are characterized by the presence of abundant extracellular myxoid or chondromyxoid matrix material. Fine needle aspiration (FNA) is variably used for diagnosing primary, recurrent, and metastatic myxoid soft tissue tumors. The spectrum of myxoid soft tissue tumors encountered in practice ranges from benign lesions such as simple ganglion cysts to high-grade malignant sarcomas such as myxofibrosarcoma. These myxoid tumors have clinical, cytologic, and histologic overlap. Therefore, making an accurate diagnosis by FNA alone is challenging. Despite this challenge, using a systematic cytomorphologic approach and ancillary studies, an accurate diagnosis is feasible in the majority of cases. This article provides a systematic approach to diagnosing myxoid soft tissue tumors by FNA along with a review of the literature.

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Section: Myxofibrosarcomamentioning

confidence: 99%

Approach to FNA of Myxoid Soft Tissue Tumors

Satturwar

Wakely

Pantanowitz

2022

Advances in Anatomic Pathology

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“…The remaining 3 aspirates coupled with core‐needle biopsies had diagnoses of LPS, sarcoma, and high‐grade malignant neoplasm. Three cases erroneously diagnosed as high‐grade MFS were reported previously in a large FNA series concentrating on that neoplasm, and they were re‐reviewed for inclusion in the current study 22 . There were no cases in our files of another sarcoma or malignancy erroneously diagnosed as PLPS by FNA biopsy.…”

Section: Resultsmentioning

confidence: 94%

“…These are cells not that infrequent in tissue sections 30 or in aspirate smears of MFS. 22 The cytoplasmic, mucin-filled (rather than lipid) vacuoles of pseudolipoblasts are not as sharply defined, nor do they seem to produce the sharp concave nuclear depressions that are seen in true lipoblasts.…”

Section: Discussionmentioning

confidence: 99%

Pleomorphic liposarcoma: A clinicopathologic study of 20 FNA cases

Wakely

Wangsiricharoen

Ali

2022

Cancer Cytopathology

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BACKGROUND Pleomorphic liposarcoma (PLPS) is the least common but most aggressive of all forms of liposarcoma (LPS). Its diagnosis relies on the recognition of pleomorphic lipoblasts (PLBs), whose numbers vary considerably. Because few large fine‐needle aspiration (FNA) biopsy studies exist, the authors review their experience with PLPS. METHODS The authors’ cytopathology files were searched for PLPS with histopathologic verification. FNA biopsy smears were performed via standard techniques. RESULTS Twenty cases from 20 patients (male/female ratio, 2.3/1; age range, 22‐77 years; mean age, 58 years) met the inclusion criteria. All had tissue confirmation. Biopsy sites included the following: thigh (11 [55%]), upper extremity (4 [20%]), axilla (2 [10%]), neck (1 [5%]), chest wall (1 [5%]), and mediastinum (1 [5%]). Aspirates were from primary (17 [85%]), locally recurrent (2 [10%]), and metastatic neoplasms (1 [5%]). The FNA diagnoses were PLPS (10 [50%]), myxofibrosarcoma (4 [20%]), LPS (2 [10%]), sarcoma (2 [10%]), and high‐grade malignant neoplasm (2 [10%]). Smears showed thick cell clusters and dissociated single forms. Pleomorphic, epithelioid, and bizarre cell/nuclear shapes were common. PLBs were absent, rare, or unnoticed in 45%. In 25%, smears dominated by myxoid stroma were diagnosed as high‐grade myxofibrosarcoma or myxoid LPS. Ancillary testing performed in 5 cases had limited diagnostic efficacy. CONCLUSIONS FNA biopsy of PLPS, although able to successfully recognize malignancy, suffers from a sampling bias due to an inability to capture or recognize PLBs in a significant proportion of cases secondary to the heterogeneous composition of this neoplasm.;

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“…However, tissue diagnosis following biopsies of myxoid tumors in general and myxofibrosarcoma in particular poses a challenge [25]. In a study by Wakely et al, approximately one-third of myxofibrosarcoma cases were inaccurately diagnosed following FNA [25,27]. Ultrasound-guided core needle biopsies have shown a relatively lower negative predictive value and specificity in diagnosing malignancy in myxoid tumors [25] and a lower accuracy in heterogeneous tumors [28].…”

Section: Us-guided Biopsies Of Myxofibrosarcomasmentioning

confidence: 99%

Ultrasound of myxofibrosarcoma

Morag

Lucas

2021

Skeletal Radiol

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The ultrasound appearance of myxofibrosarcoma is highly variable corresponding to its variable and at times heterogeneous histopathologic appearance. Myxofibrosarcomas may mimic a benign process and the infiltrative tumor margins may be difficult to precisely delineate on ultrasound imaging. These tumor characteristics pose a diagnostic challenge on ultrasound evaluation. The radiologist should be aware of the variable morphologic presentation and infiltrative nature of myxofibrosarcoma and the limitations of ultrasound in the initial diagnosis, biopsy guidance, and post-surgical follow-up of this tumor.

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Cytopathology of myxofibrosarcoma: a study of 66 cases and literature review

Cited by 15 publications

References 26 publications

Approach to FNA of Myxoid Soft Tissue Tumors

Approach to FNA of Myxoid Soft Tissue Tumors

Pleomorphic liposarcoma: A clinicopathologic study of 20 FNA cases

Ultrasound of myxofibrosarcoma

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