Cytology of spindle cell sarcomas-An institutional experience

Abstract

Introduction: Spindle cell sarcomas are a heterogeneous group including various histopathologic entities. Grading of these tumors is the most important prognostic factor and has a bearing on patient management. Cytology is well established tool for primary diagnosis of spindle cell sarcomas, particularly for recurrent and metastatic lesions. Herein, we describe our experience with respect to morphology and cytologic grading of spindle cell sarcomas and its histology correlation. Aims and objectives of this study is to analyse cytological features of soft tissue spindle cells sarcomas and to grade spindle cells sarcomas on cytology and to correlate with corresponding grading on histology wherever available. Materials and Methods: All spindle cell sarcomas diagnosed on FNAC from January 2007 to May 2012 were included in the study. May-Grunwald-Giemsa and Pap stained smears with minimum of 4 slides with at least 20 clusters were examined for each case. The sarcomas were subtyped wherever possible. Cytologic and histopathologic grading was performed using Weir et al criteria and FNLCC system respectively. The histopathology was correlated with the help of cell block, biopsy or subsequent resections. Summary and Conclusion: Primary diagnosis of sarcoma is possible on FNAC with good clinical and imageological correlation along with the use of ancillary techniques like Immunocytochemistry Sub-typing is challenging for spindle cell sarcomas due to complex heterogeneity and morphological overlap. Subtyping is possible for Synovial sarcomas. There is an overall 81.8% concordance on grading. Though useful, Cytologic grading cannot be used as a single tool for prognostication. There is a need to modify the histologic criteria of grading so that more accurate and precise Cytologic grading can be possible. Keywords: Spindle cell sarcoma, Cytology, Histology, Subtyping, Grading.