Fine needle aspiration biopsy in the diagnosis of mediastinal lesions

Forty‐two fine‐needle aspirates (FNA) of the mediastinum were reviewed from 1984–1995. The clinical, radiologic, pathologic, and cytologic material was studied. Twenty‐five males and 17 females had an age range from 10–72 yr and a mean of 41 yr. Common complaints were chest pain, dyspnea, and cough. Thirty‐eight tumors were in the anterior/superior mediastinum. Fifty‐seven percent were primary neoplasms (Hodgkin's lymphoma, 7; non‐Hodgkin's lymphoma, 6; thymoma, 3; germ‐cell tumor, 3; thymic carcinoid and angiosarcoma, 1 each; and malignant not otherwise specified, 3). Twenty‐four percent were metastatic tumors (carcinoma, 9; and sarcoma, 1). Twelve percent were benign conditions (granulomatous disease, 2; multinodular goiter, 1; extramedullary hematopoesis, 1; and one thymic cyst). Seven percent were inconclusive. FNA yielded adequate tissue for diagnosis in 83% and a correct diagnosis in 86%. There was one false‐negative and no false‐positive diagnosis. FNA is a useful tool for accurate tissue diagnosis of mediastinal masses. Diagn. Cytopathol. 1998;19:428–436. © 1998 Wiley‐Liss, Inc.

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“…2,4,8,15 In our study, these cases were readily diagnosed by FNA alone. 2,4,8,15 In our study, these cases were readily diagnosed by FNA alone.…”

Section: Discussionmentioning

confidence: 52%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] We reviewed our experience with FNA of the mediastinum to assess its role in this setting. It is the site of a myriad of nonneoplastic and neoplastic conditions both benign and malignant, primary and metastatic, many of which present as mediastinal masses.…”

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confidence: 99%

Fine-needle aspiration of the mediastinum: A clinical, radiologic, cytologic, and histologic study of 42 cases

et al. 1998

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“…[11][12][13] Briefly, the smear technique consisted of smearing expressed material on a slide with a second slide and spreading this material over a small area, similar to the technique used for a bone marrow aspirate. The techniques of aspiration, smear preparation, and staining methods were similar to previously described methods.…”

Section: Methodsmentioning

confidence: 99%

“…[1][2][3][4][5] Although a variety of mediastinal masses share similar clinical and radiographic features, the differential diagnosis is primarily influenced by the clinical findings, mediastinal compartment involved, and the age of the patient. 1,3,4,[6][7][8][9][10][11] However, the wide variety of lesions that can occur in the mediastinum and the frequent lack of differentiation of these malignancies can occasionally create diagnostic problems. 1,3,4,[6][7][8][9][10][11] However, the wide variety of lesions that can occur in the mediastinum and the frequent lack of differentiation of these malignancies can occasionally create diagnostic problems.…”

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confidence: 99%

Diagnostic pitfalls in fine‐needle aspiration biopsy of the mediastinum

et al. 1997

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A retrospective review of 189 fine-needle aspiration (FNA) biopsies of the mediastinum from four university medical centers was performed. Review of Diff-Quik-and Papanicolaou-stained direct smears was performed from a series of 189 FNA biopsies along with surgical pathology correlation obtained in 42% of the cases. There were 28 (14.8%) nondiagnostic or unsatisfactory for diagnosis cases. Of the satisfactory FNA specimens with histologic correlation, 12 cases (6%) were discordant. These errors primarily involve subclassification of small-cell malignancies involving the mediastinum, including a misdiagnosis of small-cell carcinoma for lymphoma. Large-cell lesions that were problematic included the accurate diagnosis of Hodgkin's lymphoma including the separation from non-Hodgkin's lymphoma. Large-cell lymphoma with sclerosis was misinterpreted in two cases due to distortion of cells by the mesenchymal tissue and sparsely cellular smears. In two cases classification of primary germ-cell tumors and separation from metastatic carcinoma was a problem. In general, FNA of the mediastinum is an accurate procedure, but can be challenging in a minority of cases due to sparse cellularity of the lesions and accurate classification of a variety of neoplasms that occur in this region. These 12 discordant cases serve as the basis of our report.

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“…2,[4][5][6][7] The cytologic features of both primary and metastatic malignancies of the mediastinum have been well described. 1,3,4,[6][7][8][9][10][11] However, the wide variety of lesions that can occur in the mediastinum and the frequent lack of differentiation of these malignancies can occasionally create diagnostic problems. We report 12 cases (6%) out of a total series of 189 FNA biopsies of the mediastinum with discordant FNA and histologic correlations.…”

mentioning

confidence: 99%

Diagnostic pitfalls in fine-needle aspiration biopsy of the mediastinum

et al. 1997

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A retrospective review of 189 fine‐needle aspiration (FNA) biopsies of the mediastinum from four university medical centers was performed. Review of Diff‐Quik‐ and Papanicolaou‐stained direct smears was performed from a series of 189 FNA biopsies along with surgical pathology correlation obtained in 42% of the cases. There were 28 (14.8%) nondiagnostic or unsatisfactory for diagnosis cases. Of the satisfactory FNA specimens with histologic correlation, 12 cases (6%) were discordant. These errors primarily involve subclassification of small‐cell malignancies involving the mediastinum, including a misdiagnosis of small‐cell carcinoma for lymphoma. Large‐cell lesions that were problematic included the accurate diagnosis of Hodgkin's lymphoma including the separation from non‐Hodgkin's lymphoma. Large‐cell lymphoma with sclerosis was misinterpreted in two cases due to distortion of cells by the mesenchymal tissue and sparsely cellular smears. In two cases classification of primary germ‐cell tumors and separation from metastatic carcinoma was a problem. In general, FNA of the mediastinum is an accurate procedure, but can be challenging in a minority of cases due to sparse cellularity of the lesions and accurate classification of a variety of neoplasms that occur in this region. These 12 discordant cases serve as the basis of our report. Diagn. Cytopathol. 17:121–126, 1997. © 1997 Wiley‐Liss, Inc.

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Fine needle aspiration biopsy in the diagnosis of mediastinal lesions

Cited by 34 publications

References 5 publications

Fine-needle aspiration of the mediastinum: A clinical, radiologic, cytologic, and histologic study of 42 cases

Fine-needle aspiration of the mediastinum: A clinical, radiologic, cytologic, and histologic study of 42 cases

Diagnostic pitfalls in fine‐needle aspiration biopsy of the mediastinum

Diagnostic pitfalls in fine-needle aspiration biopsy of the mediastinum

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