Soft tissue and musculoskeletal system

Nodular Fasciitis of the Nose and External Auditory Canal: Two Rare Case Reports

Nodular fasciitis(NF) is a proliferative disease of fibroblasts and myofibroblasts that generally affects subcutaneous tissue, muscle tissue, and fascia. NF usually occurs in young adults aged 20-40 and is more common in the upper extremities and relatively rare in the region of the head and neck. Here, we report on two patients with NF in the ear and nose. Under general anesthesia, the masses of NF were completely resected along the safety margin. The patients recovered well after surgery and there was no recurrence after more than half a year of follow-up.

Cytological diagnosis of angiomatoid fibrous histiocytoma: Report of a case and review of literature

Angiomatoid fibrous histiocytoma (AFH) is an unusual superficially located tumor primarily affecting children and young adults. It grows slowly and most often occurs on the extremities. There is a paucity of literature on the cytological findings of AFH owing to the rarity of the lesion and its superficial location which makes it easier to perform the biopsy. Here, we present a case of AFH in a 7-year-old girl who presented with a left upper arm swelling. The cytology of this tumor along with histopathologic correlation and review of literature is discussed.

Cytological Diagnosis and Misdiagnosis of Nodular Fasciitis

Background

Nodular fasciitis (NF) is a rapidly growing, self-limiting, subcutaneous nodular cytologic exuberant fibroblastic/myofibroblastic proliferation prone to cytological misdiagnosis.

Aims

This study aimed at finding out the utility of fine needle aspiration cytology (FNAC) from NF patients and to validate the diagnostic features.

Materials and Methods

The study group comprised 11 cases diagnosed as NF on cytology or subsequent histology.

Results

Out of 11 cases, 9 were cytologically diagnosed as NF. Two cases were misdiagnosed as sarcoma as proven histologically. Of the 9 cases of NF, spontaneous resolution occurred in 7 cases in 2-16 weeks; excisional biopsy was undertaken in the other 2 cases.

Conclusion

On cytology, NF reveals hypercellular, polymorphic, dispersed cell population, which is most commonly misdiagnosed as sarcoma. For this reason, FNAC has to be correlated with clinical data and followed up for the anticipated spontaneous regression.

Cytological diagnosis of osteoblastoma of the talus: Case report with unusual presentation and diagnostic pitfalls

Osteoblastoma is a rare bone tumor mostly affecting the young adults and commonly involving the spinal cord and long bones. Talus is the uncommon site of presentation, and if involved, then the neck is more commonly involved than the body of talus. The cytological diagnosis of osteoblastoma is limited, and to the best of our knowledge, its fine-needle aspiration (FNA) in the talus has still not been reported in the literature. The present case of osteoblastoma is, therefore, being reported due to the unusual presentation in elderly male in the body of talus and showing extensive involvement on X-ray. The case was initially diagnosed on FNA cytology excluding the possibility of giant-cell tumor and osteosarcoma. The case also highlights the importance of vigilant observation of subtle cytological features of this rare tumor which may be helpful in avoiding diagnostic pitfalls, especially at an uncommon site and with unusual presentation. An early precise diagnosis by cytology may be followed by appropriate treatment and thus avoiding any further complications.

Hypercellular round cell liposarcoma: A comprehensive cytomorphologic study and review of 8 cases

Background:

Myxoid and round cell liposarcomas (RCL) are low and high-grade counterparts of a common subtype of liposarcomas (LPS), representing a histologic continuum.

Aims:

The aim was to study the cytomorphology of hypercellular RCL and to look for features that differentiate RCL from other sarcomas displaying round cells with myxoid change.

Materials and Methods:

Eight cases of hypercellular RCL were identified retrospectively in which round cell component constituted greater than 75% of the area. Cytomorphological features were studied in detail.

Results:

Four cases were predominantly composed of round cells, out of which 2 were entirely composed of round cells. Myxoid metachromatic stroma was absent in 2 cases, while it was present in ample amounts in the remaining 6 cases. Spindle cells were completely absent in 5 cases and lipoblasts were observed in a single case of RCL. Plexiform vascular capillaries were seen in 4 cases. Adherence of neoplastic round cells around thin capillaries (ANAC) was observed in 7 cases.

Conclusions:

Plexiform capillary plexus and ANAC should be separately evaluated. The latter feature is the most consistent one, and is an important clue to the adipocytic nature of the neoplasm when hypercellular round cell areas are aspirated. Confident diagnosis of hypercellular RCL can be made on the basis of this feature. Lipoblasts, although specific, are seen in few cases. The rest of the features are nonspecific and useful only in combination.