Subtyping and grading of synovial sarcomas: a cyto-histopathologic correlation study
Keywords:
Synovial sarcoma, FNAC, Grading, Cytology, Soft tissue tumor,
Abstract
Introduction: Synovial sarcoma is a mesenchymal spindle cell tumor which displays variable epithelial differentiation, including glandular formation and has a specific chromosomal translocation t(X; 18). Fine-needle aspiration cytology (FNAC) is increasingly accepted as a valid screening technique with high sensitivity and specificity in establishing the presence of malignancy and determining the mesenchymal nature of a lesion.Aims and Objectives: In this present study, cytological features, subtyping and grading were studied retrospectively from the histologically confirmed 14 cases of synovial sarcomas and then subsequently correlated our findings from histology section.Methods: This is a retrospective study conducted in Central Institute of Orthopedic (CIO) laboratory. A total 14 cases with a diagnosis of synovial sarcomas from CIO laboratory from past 4 years were retrieved and reviewed for cytohistological correlation, subtyping and grading of synovial sarcoma.Results: Out of total 14 cases of histological proven synovial sarcomas, 12 cases were exactly subtype on cytology. The cytological grading was only similar in 7 of 13 cases that were graded.Conclusion: FNAC is an important and useful tool in diagnosing and subtyping synovial sarcoma.References
1. Storlazzi CT, Mertens F, Mandahl N, Gisselsson D, Isaksson M, Gustafson P, et al. A novel fusion gene, SS18L1/SSX1, in synovial sarcoma. Genes Chromosom. Cancer; 2003:37:195-200.
2. Layfield LJ. Fine needle aspiration of the musculoskeletal system. In: Atkinson BF, Silverman JF (Eds). Atlas of Difficult Diagnoses in Cytopathology. Philadelphia: WB Saunders Company; 1998. pp. 481-506.
3. Jones C, Liu K, Hirschowitz S, Klipfel N, Layfield LJ. Concordance of histopathologic and cytologic grading in musculoskeletal sarcomas: can grades obtained from analysis of the fine-needle aspirates serve as the basis for therapeutic decisions? Cancer. 2002;96:83-91.
4. Fletcher CD, Rydholm A, Singer S. WHO classification of soft tissue tumors. In: World Health Organization Classification of Tumors. Pathology and Genetics. Tumors of Soft Tissue and Bone. Lyon, France: IARC press; 2002. pp. 5-6.
5. Kilpatrick SE, Cappellari JO, Bos GD, Gold SH, Ward WG. Is fine-needle aspiration biopsy a practical alternative to open biopsy for the primary diagnosis of sarcoma? Experience with 140 patients. Am J Clin Pathol. 2001;115:59-68.
6. Domaniski H, Akerman M, Engellau J, Gustafson P, Mertens F, Rydholm A. Fine-needle aspiration of neurilemoma (Schwannoma): A clinicocytopathological study of 116 patients. Diagn Cytopathol. 2006;34:403-12.
7. Domanski H. Fine-needle aspiration cytology of soft tissue lesions: diagnostic challenges. Diagn Cytopathol. 2007;35:768-73.
8. Costa MJ, Campman SC, Davis RL, Howell LP. Fine-needle aspiration cytology of sarcoma: Retrospective review of diagnostic utility and specificity. Diagn Cytopathol. 1996;1523-32.
9. Nagira K, Yamamoto T, Akisue T, Marui T, Hitora T, Nakatani T, et al. Reliability of fine-needle aspiration biopsy in the initial diagnosis of soft-tissue lesions. Diagn Cytopathol. 2002;27:354-61.
10. Akerman M, Wille´n H, Carle´n B, Mandahl N, Mertens F. Fine-needle aspiration (FNA) of synovial sarcoma—a comparative histological cytological study of 15 cases, including immunohistochemical, electron microscopic and cytogenetic examination and DNA-ploidy analysis. Cytopathol. 1996;7:187-200.
11. Weiss SW, Goldblum JR. Malignant soft tissue tumors of uncertain type. Enzinger and Weiss Soft Tissue Tumors, 4th edition. St. Louis, London: Mosby; 2001. pp. 1093-160.
12. Åkerman M, Ryd W, Skytting B. Fine-needle aspiration of synovial sarcoma: criteria for diagnosis: retrospective reexamination of 37 cases, including ancillary diagnostics. A Scandinavian Sarcoma Group Study. Diagn. Cytopathol. 2003;28:232-8.
13. Ryan MR, Stastny JF, Wakely PE. The cytopathology of synovial sarcoma. A study of six cases, with emphasis on architecture and histopathologic correlation. Cancer (Cancer Cytopathol). 1998;84:42-9.
14. Nilsson G, Wang M, Wejde J, et al. Reverse transcriptase polymerase chain reaction on fine needle aspirates for rapid detection of translocations in synovial sarcoma. Acta Cytol. 1998;42:1317-24.
15. Viguer JM, Jime´nez-Heffernan JA, Vicandi B, Lo´pez-Ferrer P, Gamallo C. Cytologic features of synovial sarcoma with emphasis on the monophasic fibrous variant. A morphologic and immunocytochemical analysis of bcl-2 protein expression. Cancer (Cancer Cytopathol). 1998;84:50-6.
16. Klijanienko J, Caillaud JM, Lagace R, Vielh P. Cytohistologic correlations in 56 synovial sarcomas in 36 patients: The Institut Curie Experience. Diagn Cytopathol. 2002;27:96-102.
17. Mathur S, Kapila K, Verma K. Accuracy of cytological grading of spindle-cell sarcomas. Diagn Cytopathol. 2003;29(2):79-83.
18. Weir MM, Rosenberg AE, Bell DA. Grading of spindle cell sarcomas in fine-needle aspiration biopsy specimens. Am J Clin Pathol. 1999;112:784-90.
19. Palmer HE, Mukunyadzi, Culbreth W, Thomas JR. Sub grouping and grading of soft tissue tumors by fine needle aspiration cytology: A histopathologic correlation study. Diagn Cytopathol. 2001;24:307-16.
20. Mallik MK, Dey P, Gupta SK, Vasishta RK. Grading of soft tissue sarcomas on fine-needle aspiration cytology smear. Diagn Cytopathol. 2010;38:109-12.
2. Layfield LJ. Fine needle aspiration of the musculoskeletal system. In: Atkinson BF, Silverman JF (Eds). Atlas of Difficult Diagnoses in Cytopathology. Philadelphia: WB Saunders Company; 1998. pp. 481-506.
3. Jones C, Liu K, Hirschowitz S, Klipfel N, Layfield LJ. Concordance of histopathologic and cytologic grading in musculoskeletal sarcomas: can grades obtained from analysis of the fine-needle aspirates serve as the basis for therapeutic decisions? Cancer. 2002;96:83-91.
4. Fletcher CD, Rydholm A, Singer S. WHO classification of soft tissue tumors. In: World Health Organization Classification of Tumors. Pathology and Genetics. Tumors of Soft Tissue and Bone. Lyon, France: IARC press; 2002. pp. 5-6.
5. Kilpatrick SE, Cappellari JO, Bos GD, Gold SH, Ward WG. Is fine-needle aspiration biopsy a practical alternative to open biopsy for the primary diagnosis of sarcoma? Experience with 140 patients. Am J Clin Pathol. 2001;115:59-68.
6. Domaniski H, Akerman M, Engellau J, Gustafson P, Mertens F, Rydholm A. Fine-needle aspiration of neurilemoma (Schwannoma): A clinicocytopathological study of 116 patients. Diagn Cytopathol. 2006;34:403-12.
7. Domanski H. Fine-needle aspiration cytology of soft tissue lesions: diagnostic challenges. Diagn Cytopathol. 2007;35:768-73.
8. Costa MJ, Campman SC, Davis RL, Howell LP. Fine-needle aspiration cytology of sarcoma: Retrospective review of diagnostic utility and specificity. Diagn Cytopathol. 1996;1523-32.
9. Nagira K, Yamamoto T, Akisue T, Marui T, Hitora T, Nakatani T, et al. Reliability of fine-needle aspiration biopsy in the initial diagnosis of soft-tissue lesions. Diagn Cytopathol. 2002;27:354-61.
10. Akerman M, Wille´n H, Carle´n B, Mandahl N, Mertens F. Fine-needle aspiration (FNA) of synovial sarcoma—a comparative histological cytological study of 15 cases, including immunohistochemical, electron microscopic and cytogenetic examination and DNA-ploidy analysis. Cytopathol. 1996;7:187-200.
11. Weiss SW, Goldblum JR. Malignant soft tissue tumors of uncertain type. Enzinger and Weiss Soft Tissue Tumors, 4th edition. St. Louis, London: Mosby; 2001. pp. 1093-160.
12. Åkerman M, Ryd W, Skytting B. Fine-needle aspiration of synovial sarcoma: criteria for diagnosis: retrospective reexamination of 37 cases, including ancillary diagnostics. A Scandinavian Sarcoma Group Study. Diagn. Cytopathol. 2003;28:232-8.
13. Ryan MR, Stastny JF, Wakely PE. The cytopathology of synovial sarcoma. A study of six cases, with emphasis on architecture and histopathologic correlation. Cancer (Cancer Cytopathol). 1998;84:42-9.
14. Nilsson G, Wang M, Wejde J, et al. Reverse transcriptase polymerase chain reaction on fine needle aspirates for rapid detection of translocations in synovial sarcoma. Acta Cytol. 1998;42:1317-24.
15. Viguer JM, Jime´nez-Heffernan JA, Vicandi B, Lo´pez-Ferrer P, Gamallo C. Cytologic features of synovial sarcoma with emphasis on the monophasic fibrous variant. A morphologic and immunocytochemical analysis of bcl-2 protein expression. Cancer (Cancer Cytopathol). 1998;84:50-6.
16. Klijanienko J, Caillaud JM, Lagace R, Vielh P. Cytohistologic correlations in 56 synovial sarcomas in 36 patients: The Institut Curie Experience. Diagn Cytopathol. 2002;27:96-102.
17. Mathur S, Kapila K, Verma K. Accuracy of cytological grading of spindle-cell sarcomas. Diagn Cytopathol. 2003;29(2):79-83.
18. Weir MM, Rosenberg AE, Bell DA. Grading of spindle cell sarcomas in fine-needle aspiration biopsy specimens. Am J Clin Pathol. 1999;112:784-90.
19. Palmer HE, Mukunyadzi, Culbreth W, Thomas JR. Sub grouping and grading of soft tissue tumors by fine needle aspiration cytology: A histopathologic correlation study. Diagn Cytopathol. 2001;24:307-16.
20. Mallik MK, Dey P, Gupta SK, Vasishta RK. Grading of soft tissue sarcomas on fine-needle aspiration cytology smear. Diagn Cytopathol. 2010;38:109-12.
Published
2015-05-10
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
