Fine needle aspiration cytology (FNAC) of cystic soft tissue lesions and end tissue metamorphosis-a three year study

Abstract

Objective: Superficial soft-tissue masses may be seen in clinical practice, but a systematic approach may help to achieve a definitive diagnosis or differential diagnosis for soft tissue lesions. The cystic lesions constitute a heterogeneous group with highly varied etiology, cytology and diversified histopathology. The aim of this study is to investigate the accuracy of FNAC diagnosis of varied cystic lesions of soft tissue lesions by comparing with the radiological and histopathology diagnosis. Materials and methods: Fine needle aspirations were done using a 22-24 gauge disposable needle and a 5cc to 10 cc disposable syringe for suction. Wet-fixed smears with isopropyl alcohol were stained with hematoxylin and eosin (HxE). Dry-fixed smears were stained with Leishman Giemsa along with Papanicolaou stains (PAP) were studied for cytological details and diagnosis. The excised surgical specimen and biopsy samples of the cases were processed routinely and stained with HxE and immunohistochemistry (IHC) panel was applied. Results: Examined cystic soft-tissue masses were found as superficial (82%) and deep (18%). Superficial lesions were categorized into mesenchymal tumors, skin appendage lesions, tumor like lesions, pseudoudo tumoural soft tissue lesions or parasitic /inflammatory lesions. Deeper lesions with cystic presentation were mostly (74%) malignant. The differential diagnosis was done according to the age of the patient, anatomic location of the lesion, salient imaging features and clinical manifestations. Conclusion: Although the fine needle aspiration cytology of the cystic lesions, imaging characteristics of the lesions discussed are not always corresponding to the histopathologic findings what we assume, combining them with lesion location and clinical features may allow the diagnosticians to suggest a specific diagnosis in most cases.