Subtyping and grading of synovial sarcomas: a cyto-histopathologic correlation study

Authors

  • Ankit Kaushik VMMC and Safdarjung Hospital, GGSIPU
  • Geetika Khanna
  • Rajni .
  • Yogesh Kumar Yadav

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. Ã…kerman 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.

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Published

10-05-2015

How to Cite

1.
Kaushik A, Khanna G, . R, Yadav YK. Subtyping and grading of synovial sarcomas: a cyto-histopathologic correlation study. Ann of Pathol and Lab Med [Internet]. 2015 May 10 [cited 2024 Dec. 22];2(2):A81-85. Available from: http://pacificejournals.com/journal/index.php/apalm/article/view/112

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