Fine-needle aspiration cytology and core needle biopsy in the preoperative diagnosis of desmoid tumors

Abstract

Background Desmoid tumors have a tendency to recur locally, and traditionally they have been treated surgically. No treatment is sometimes indicated, however; this requires a morphological diagnosis that is not based on a surgical specimen. In this study we aimed to identify the diagnostic accuracy of needle and core biopsy for the morphological diagnosis of desmoid.Methods We compared the diagnostic accuracy of fine-needle aspiration (FNA) and core needle biopsy (CNB) in 69 and 26 patients, respectively, who had had surgical resections for desmoid. We also reviewed 15 additional cases that had been incorrectly diagnosed as desmoid on FNA but which had different diagnoses after surgery.Results FNA-based diagnoses of desmoid/fibromatosis were rendered in 35 of 69 cases, and other benign spindle cell proliferations in 26 cases and spindle cell sarcoma in the remaining 4 cases. All 26 CNBs were either suggested to correspond to desmoid (24) or other benign spindle cell lesions (2). Of the 15 FNAs incorrectly diagnosed as desmoid, 2 were found to be sarcomas.Interpretation FNA is fairly reliable for recognition of the benign nature of desmoids. Occasional over-and under-diagnosis of malignancy can occur, however. CNB appears to be more reliable.

Chromosome banding analysis of cells from fine-needle aspiration biopsy samples from soft tissue and bone tumors: is it clinically meaningful?

“…Both needle techniques are in most cases easy to perform, cost effective and well tolerated by the patient [2]. In Scandinavia, the further management of the patient is decided upon the pretreatment diagnosis made on tumor cells from FNA and/or tissue from CN biopsies, combined with clinical and radiographic information [3]. Apart from the morphologic evaluation of tumor cells in FNA and CN biopsies, ancillary techniques, such as immunocytochemistry/immunohistochemistry, are often used to improve the diagnostic precision.…”

Aspiration biopsy cytology of extraabdominal desmoid tumor concurrently occurring in a patient with tumoral calcinosis

“…Fragments of dense collagenized stroma or matrix can also be seen. 12,13 The FNA biopsy of our case was moderately cellular and displayed variable size tissue fragments with frayed periphery. The fragments were syncytial 3-dimentional and occasional loose clusters or singly dispersed cells were seen.…”

Fine-Needle Aspiration Followed by Core-Needle Biopsy in the Same Setting: Modifying Our Approach

“…Table 4 summarizes the advantages of the combined procedure. Therefore, and as shown by other investigators, the utilization of both aspirate smears and core tissue biopsy material are complementary and have added value compared to either one alone [7,13,26,29,33,35,38,39,44,45,46,47,50,51,52,57,58,59,60,61,62,68,75,76,77,78]. …”

“…Seven of the sarcoma cases that were diagnosed by FNAB were further subtyped by CNB. In their study that aimed to identify the diagnostic accuracy of FNAB and CNB in diagnosing desmoid tumors, Dalén et al [59] showed that 35 out of 69 (50.7%) cases were diagnosed by FNAB and 24 out of 26 (92.3%) cases were diagnosed by CNB. These findings confirm that CNB is more reliable than FNAB in diagnosing soft tissue lesions, and using the two modalities together would significantly improve the diagnostic accuracy in soft tissue lesions [39,57,59].…”