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Zytologische Sarkomdiagnostik

Cytologic diagnosis of sarcoma

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Zusammenfassung

Weichteilschwellungen sind das Symptom einer Vielzahl neoplastischer und nichtneoplastischer Veränderungen. Sarkome gehören zu den selteneren Ursachen. Die Feinnadelpunktion (FNP) hat sich in der Abgrenzung zu entzündlichen Prozessen sowie in der Abklärung von Tumorrezidiven und Karzinommetastasen als minimal-invasive, kostengünstige und zuverlässige Methode bewährt. Auch in der Abklärung von Weichteiltumoren kann sie zu einer präzisen Diagnose führen. Voraussetzung ist eine enge multidisziplinäre Zusammenarbeit unter Einbeziehung klinischer, radiologischer und morphologischer Befunde. Für die zytologische Befundung sind Alter und Geschlecht sowie Topographie, Größe und Wachstumsgeschwindigkeit des Tumors wichtige Parameter. Reifungsgrad und Form der Zellen sowie Vorhandensein und Ausdifferenzierung der bindegewebigen Matrix bieten erste differenzialdiagnostische Hinweise und sind der Ausgangspunkt für immunzytochemische und molekularbiologische (FISH, RT-PCR) Zusatzuntersuchungen. Diese Untersuchungen werden an Direktausstrichen, an mittels Zellblockmethode eingebettetem und an tiefgefrorenem Punktionsmaterial ausgeführt.

Abstract

Soft tissue swelling represents a common clinical sign of a variety of neoplastic and non-neoplastic lesions. Sarcoma is rarely a cause. Fine needle biopsy as a minimally invasive, economic and accurate method is well suited for the diagnosis of inflammatory/infectious processes as well as of recurrent and metastatic disease. Cytologic diagnosis of primary soft tissue tumors is also feasible. It requires close collaboration with other medical disciplines and incorporation of clinical, radiological and morphologic findings. Clinical data such as age, gender, size and topography are important parameters. The differentiation of cells and properties of the extracellular matrix supplies clues for the differential diagnosis and forms the starting point for immunohistochemical or molecular analysis (FISH, RT-PCR). This analysis may be performed on cytological smears, paraffin embedded material of the cell blocks or on frozen material.

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Literatur

  1. Akerman M, Domanski HA (2003) The cytology of soft tissue tumours. Karger, New York

  2. Colin P, Lagace R, Caillaud JM et al (2010) Fine-needle aspiration in myxofibrosarcoma: experience of Institut Curie. Diagn Cytopathol 38:343–346

    PubMed  Google Scholar 

  3. Das K, Hameed M, Heller D et al (2003) Liquid-based vs. conventional smears in fine needle aspiration of bone and soft tissue tumors. Acta Cytol 47:197–201

    PubMed  Google Scholar 

  4. Dodd LG, Martinez S (2001) Fine-needle aspiration cytology of pseudosarcomatous lesions of soft tissue. Diagn Cytopathol 24:28–35

    Article  CAS  PubMed  Google Scholar 

  5. Domanski HA (2005) FNA diagnosis of dermatofibrosarcoma protuberans. Diagn Cytopathol 32:299–302

    Article  PubMed  Google Scholar 

  6. Domanski HA, Akerman M, Carlen B et al (2005) Core-needle biopsy performed by the cytopathologist: a technique to complement fine-needle aspiration of soft tissue and bone lesions. Cancer 105:229–239

    Article  PubMed  Google Scholar 

  7. Domanski HA, Akerman M, Rissler P et al (2006) Fine-needle aspiration of soft tissue leiomyosarcoma: an analysis of the most common cytologic findings and the value of ancillary techniques. Diagn Cytopathol 34:597–604

    Article  PubMed  Google Scholar 

  8. Domanski HA, Mertens F, Panagopoulos I et al (2009) Low-grade fibromyxoid sarcoma is difficult to diagnose by fine needle aspiration cytology: a cytomorphological study of eight cases. Cytopathology 20:304–314

    Article  CAS  PubMed  Google Scholar 

  9. Fletcher CDM, Unni KK, Mertens F (2002) (Hrsg) Tumours of soft tissue and bone. IARC, Lyon

  10. Frostad B, Tani E, Brosjo O et al (2002) Fine needle aspiration cytology in the diagnosis and management of children and adolescents with Ewing sarcoma and peripheral primitive neuroectodermal tumor. Med Pediatr Oncol 38:33–40

    Article  CAS  PubMed  Google Scholar 

  11. Gautam U, Srinivasan R, Rajwanshi A et al (2010) Reverse transcriptase-polymerase chain reaction as an ancillary molecular technique in the diagnosis of small blue round cell tumors by fine-needle aspiration cytology. Am J Clin Pathol 133:633–645

    Article  CAS  PubMed  Google Scholar 

  12. Geisinger KR, Abdul-Karim FW (2008) Fine needle aspiration biopsy of soft tissue tumors. In: Weiss SW, Goldblum JR (Hrsg) Enzinger and Weiss’s soft tissue tumors. Mosby Elsevier, St. Louis, S 103–117

  13. Jakowski JD, Mayerson J, Wakely PE Jr (2010) Fine-needle aspiration biopsy of the distal extremities: a study of 141 cases. Am J Clin Pathol 133:224–231

    Article  PubMed  Google Scholar 

  14. Kaffenberger BH, Wakely PE Jr, Mayerson JL (2010) Local recurrence rate of fine-needle aspiration biopsy in primary high-grade sarcomas. J Surg Oncol 101:618–621

    Article  PubMed  Google Scholar 

  15. Kilpatrick SE, Bergman S, Pettenati MJ et al (2006) The usefulness of cytogenetic analysis in fine needle aspirates for the histologic subtyping of sarcomas. Mod Pathol 19:815–819

    CAS  PubMed  Google Scholar 

  16. Kilpatrick SE, Ward WG, Bos GD (2000) The value of fine-needle aspiration biopsy in the differential diagnosis of adult myxoid sarcoma. Cancer 90:167–177

    Article  CAS  PubMed  Google Scholar 

  17. Kilpatrick SE, Ward WG, Cappellari JO et al (1999) Fine-needle aspiration biopsy of soft tissue sarcomas. A cytomorphologic analysis with emphasis on histologic subtyping, grading, and therapeutic significance. Am J Clin Pathol 112:179–188

    CAS  PubMed  Google Scholar 

  18. Klijanienko J, Caillaud JM, Lagace R (2004) Fine-needle aspiration in liposarcoma: cytohistologic correlative study including well-differentiated, myxoid, and pleomorphic variants. Diagn Cytopathol 30:307–312

    Article  PubMed  Google Scholar 

  19. Klijanienko J, Caillaud JM, Lagace R et al (2002) Cytohistologic correlations in 56 synovial sarcomas in 36 patients: the Institut Curie experience. Diagn Cytopathol 27:96–102

    Article  PubMed  Google Scholar 

  20. Klijanienko J, Caillaud JM, Lagace R et al (2003) Cytohistologic correlations in angiosarcoma including classic and epithelioid variants: Institut Curie’s experience. Diagn Cytopathol 29:140–145

    Article  PubMed  Google Scholar 

  21. Klijanienko J, Caillaud JM, Lagace R et al (2002) Cytohistologic correlations of 24 malignant peripheral nerve sheath tumor (MPNST) in 17 patients: the Institut Curie experience. Diagn Cytopathol 27:103–108

    Article  PubMed  Google Scholar 

  22. Klijanienko J, Caillaud JM, Lagace R et al (2003) Fine-needle aspiration of leiomyosarcoma: a correlative cytohistopathological study of 96 tumors in 68 patients. Diagn Cytopathol 28:119–125

    Article  PubMed  Google Scholar 

  23. Layfield LJ (2002) Cytopathology of bone and soft tissue tumors. Oxford University Press, Oxford

  24. Layfield LJ, Dodd LG, Hirschowitz S et al (2010) Fine-needle aspiration of primary osseous lesions: A cost effectiveness study. Diagn Cytopathol 38:239–243

    PubMed  Google Scholar 

  25. Maitra A, Ashfaq R, Saboorian MH et al (2000) The role of fine-needle aspiration biopsy in the primary diagnosis of mesenchymal lesions: a community hospital-based experience. Cancer 90:178–185

    Article  CAS  PubMed  Google Scholar 

  26. Mallik MK, Dey P, Gupta SK et al (2010) Grading of soft tissue sarcomas on fine-needle aspiration cytology smear. Diagn Cytopathol 38:109–112

    PubMed  Google Scholar 

  27. Mathur S, Kapila K, Verma K (2003) Accuracy of cytological grading of spindle-cell sarcomas. Diagn Cytopathol 29:79–83

    Article  PubMed  Google Scholar 

  28. Ng VY, Thomas K, Crist M et al (2010) Fine needle aspiration for clinical triage of extremity soft tissue masses. Clin Orthop Relat Res 468:1120–1128

    Article  PubMed  Google Scholar 

  29. Palmer HE, Mukunyadzi P, Culbreth W et al (2001) Subgrouping and grading of soft-tissue sarcomas by fine-needle aspiration cytology: a histopathologic correlation study. Diagn Cytopathol 24:307–316

    Article  CAS  PubMed  Google Scholar 

  30. Pfeiffer DF, Bode-Lesniewska B (2006) Fine needle aspiration biopsy diagnosis of angiosarcoma after breast-conserving therapy for carcinoma supported by use of a cell block and immunohistochemistry. Acta Cytol 50:553–556

    PubMed  Google Scholar 

  31. Wakely PE Jr, Bos GD, Mayerson J (2005) The cytopathology of soft tissue mxyomas: ganglia, juxta-articular myxoid lesions, and intramuscular myxoma. Am J Clin Pathol 123:858–865

    Article  Google Scholar 

  32. Wakely PE Jr, Kneisl JS (2000) Soft tissue aspiration cytopathology. Cancer 90:292–298

    Article  PubMed  Google Scholar 

  33. Wong NL (2002) Fine needle aspiration cytology of pseudosarcomatous reactive proliferative lesions of soft tissue. Acta Cytol 46:1049–1055

    PubMed  Google Scholar 

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Danksagung

Die molekulargenetischen Analysen werden dankenswerterweise im Labor von Prof. D. Zimmerman, Institut für Pathologie, Universitätsspital Zürich durchgeführt.

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

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  1. Institut für Klinische Pathologie, Universitätsspital Zürich , Schmelzbergstr. 12, 8032, Zürich, Schweiz

    B. Bode-Lesniewska

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Correspondence to B. Bode-Lesniewska.

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Bode-Lesniewska, B. Zytologische Sarkomdiagnostik. Pathologe 32, 14–23 (2011). https://doi.org/10.1007/s00292-010-1396-9

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