Fine needle aspiration biopsy diagnosis of dedifferentiated liposarcoma: Cytomorphology and MDM2 amplification by FISH

Unmasking the Masquerade: Fine-Needle Aspiration Diagnosis of Dedifferentiated Liposarcoma Clinically Mimicking Lymphoma

A preoperative diagnosis of dedifferentiated liposarcomas (DDLPS) on fine-needle aspiration cytology (FNAC) is rare with scarce indexed literature. Herein, we describe a case of DDLPS diagnosed on fine needle aspiration which was presumed to be a lymphoma clinically and radiologically.

Fine-Needle Aspiration of Sarcomas Metastatic to Lymph Nodes: A Cytomorphologic Study over a 10-Year Period

INTRODUCTION

Metastasis of sarcomas to lymph nodes is an uncommon event in its natural history. We aimed to present our experience with fine-needle aspiration (FNA) of metastatic sarcomas to lymph nodes over a 10-year period.

MATERIAL AND METHODS

The cytopathology archives were searched for FNA of lymph nodes involved by metastatic sarcomas. Available clinicopathologic data were recorded. All slides were retrieved and reviewed.

RESULTS

Thirty-three lymph nodes, from 30 patients, with metastatic soft tissue sarcomas were identified. The lymph node metastases occurred in 16 males and 14 females (median age, 56 years). The size of the lymph nodes ranged from 1.2 to 7.5 cm (median size, 2.9 cm). The inguinal lymph nodes were the most commonly involved nodes, followed by thoracic and cervical neck nodes. The most common metastatic soft tissue sarcoma encountered was Kaposi sarcoma (n = 7, 23.3%), followed by angiosarcoma (n = 6, 20%) and rhabdomyosarcoma (n = 6, 20%). The most common site of primary soft tissue sarcoma was the head and neck (n = 8, 26.6%), followed by lower extremity (n = 7, 23.3%). The initial diagnosis of sarcoma was established in 6 cases. Seventen patients had metachronous involvement of lymph nodes, while the remaining patients had synchronous involvement. Seventen patients died of disease, and the survival after lymph node metastasis ranged from 1 to 43 months.

CONCLUSION

FNA is an accurate and effective method in the diagnosis of metastatic sarcoma to lymph nodes. Knowledge of clinical findings and primary tumor diagnosis along with careful assessment of the cytomorphology is extremely helpful for an accurate diagnosis of metastases.

Approach to Fine Needle Aspiration of Giant Cell-rich Tumors of Soft Tissue

Giant cells may be found in a wide variety of reactive and neoplastic soft tissue lesions. Because of their distinct histomorphology, they often stand out in procured samples such as fine needle aspirates. The giant cells themselves may be benign or neoplastic. However, the presence, type, and quantity of giant cells are usually not specific and in some cases can even be misleading when making a diagnosis. The aim of this review is to guide the practicing cytopathologist in narrowing their differential diagnosis when encountering one of these challenging giant cell-rich lesions of the soft tissue.

Osteoclast-Like Giant Cells: Focus on Entities Relevant to Dermatopathology and Underlying Pathogenesis

ABSTRACT

Osteoclast-like giant cells (OLGCs) resemble osteoclasts with their abundant cytoplasm and well-developed organelles. OLGCs are characteristic features of giant cell tumor of the tendon sheath and giant cell tumor of soft tissue but they have also been described in numerous other cutaneous conditions. The diagnostic and prognostic significance of the presence of OLGCs is unknown. Here, we summarize the clinical entities that can exhibit these cells to avoid a histological overlap, affecting diagnosis and management.

Molecular diagnostic testing of cytology specimens: current applications and future considerations

Molecular mechanisms of pathogenesis continue to be discovered, accelerating significant expansion of the spectrum of clinically useful molecular diagnostic tests and their incorporation into patient care algorithms. Currently, molecular assays facilitate identification of infectious processes, detection of specific constitutional and somatically acquired pathogenic mutations, guidance of therapy selection, and monitoring of treatment response and disease progression. The correlation of genomic test results with clinical, morphologic, and immunophenotypic findings has defined the practice of "precision medicine" with wide-reaching implications for health care. As novel promising techniques such as microarrays and next-generation sequencing are adopted by health care providers, new practice standards are being developed for incorporation into practice. Cytology specimens are good sources of high-quality nucleic acids. Although sometimes limited in quantity, in many cases such specimens are well suited for molecular diagnostic testing, which is capable of maximizing the number of tests from small amounts of sample. The pathologist continues to serve as a central resource for diagnostic testing and consultation regarding appropriate use of molecular tests. Understanding current methodologies, clinical utility of currently available nucleic acid tests, validation requirements for test implementation, quality assurance metrics, and future technology trends is essential to the practice of contemporary molecular pathology.

Ultrasound-guided fine-needle aspiration of a posterior neck dedifferentiated liposarcoma with MDM2 fluorescence in situ hybridization performed on a Pap-stained smear

Head and neck liposarcomas, while rare, tend to be subcutaneous and well-differentiated. Dedifferentiated liposarcomas of the head and neck are exceedingly rare in the literature. We present a case of a dedifferentiated liposarcoma arising in the soft tissue of the posterior neck of an 86-year-old man and diagnosed by fine-needle aspiration. Aspirate smears showed a dual population of atypical lipomatous and spindled cells. MDM2 (murine double minute 2) amplification was demonstrated on a Pap-stained smear using fluorescence in situ hybridization (FISH). To the best of our knowledge, this is the first report of MDM2 FISH amplification in a liposarcoma performed on an aspirate smear.

Authors attain comparable or slightly higher rates of citation publishing in an open access journal (CytoJournal) compared to traditional cytopathology journals - A five year (2007-2011) experience

BACKGROUND

The era of Open Access (OA) publication, a platform which serves to better disseminate scientific knowledge, is upon us, as more OA journals are in existence than ever before. The idea that peer-reviewed OA publication leads to higher rates of citation has been put forth and shown to be true in several publications. This is a significant benefit to authors and is in addition to another relatively less obvious but highly critical component of the OA charter, i.e. retention of the copyright by the authors in the public domain. In this study, we analyzed the citation rates of OA and traditional non-OA publications specifically for authors in the field of cytopathology.

DESIGN

We compared the citation patterns for authors who had published in both OA and traditional non-OA peer-reviewed, scientific, cytopathology journals. Citations in an OA publication (CytoJournal) were analyzed comparatively with traditional non-OA cytopathology journals (Acta Cytologica, Cancer Cytopathology, Cytopathology, and Diagnostic Cytopathology) using the data from web of science citation analysis site (based on which the impact factors (IF) are calculated). After comparing citations per publication, as well as a time adjusted citation quotient (which takes into account the time since publication), we also analyzed the statistics after excluding the data for meeting abstracts.

RESULTS

Total 28 authors published 314 publications as articles and meeting abstracts (25 authors after excluding the abstracts). The rate of citation and time adjusted citation quotient were higher for OA in the group where abstracts were included (P < 0.05 for both). The rates were also slightly higher for OA than non-OA when the meeting abstracts were excluded, but the difference was statistically insignificant (P = 0.57 and P = 0.45).

CONCLUSION

We observed that for the same author, the publications in the OA journal attained a higher rate of citation than the publications in the traditional non-OA journals in the field of cytopathology over a 5 year period (2007-2011). However, this increase was statistically insignificant if the meeting abstracts were excluded from the analysis. Overall, the rates of citation for OA and non-OA were slightly higher to comparable.