The cytopathology of malignant peripheral nerve sheath tumor

Paul E. Wakely, Syed Z. Ali, Justin A. Bishop

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Among sarcomas, a diagnosis of malignant peripheral nerve sheath tumor (MPNST) is often one of exclusion due to the absence of unequivocally characteristic histopathology, a conclusive immunohistochemical profile, or even a unique chromosomal anomaly. Because of this, the fine-needle aspiration (FNA) cytopathology of MPNST is extremely challenging. In the current study, the authors review their FNA experience with this neoplasm. METHODS: The authors searched their combined departmental cytology files for all lesions signed out as MPNST or suspicious for MPNST, as well as their own surgical pathology files for any cases of MPNST that had corresponding cytology. FNA was performed using standard techniques. RESULTS: A total of 55 cases of MPNST, all with tissue confirmation, and 1 misdiagnosed example of melanoma were retrieved from 52 patients (M:F ratio of 1.5:1; average age, 46 years), 26 of whom had a history of neurofibromatosis type 1 (NF-1). Aspirates were from primary (27 cases), locally recurrent (14 cases), or metastatic (10 cases) MPNST; 4 primary tumor aspirates were of ex vivo specimens. Sites included the extremities (22 cases), trunk/pelvis (22 cases), head and neck (6 cases), and deep-seated masses (6 cases). FNA diagnoses were MPNST (24 patients); consistent with MPNST (5 patients); sarcoma, not otherwise specified (10 patients); atypical (3 patients); spindle cell neoplasm (6 patients); malignant neoplasm (1 patient); and nondiagnostic (3 patients). A definitive diagnosis of either MPNST or consistent with MPNST was issued in 30%, 93%, and 70%, respectively, of primary, locally recurrent, and metastatic lesions. CONCLUSIONS: FNA cytopathology is limited as a diagnostic instrument for the initial diagnosis of MPNST, but is exceedingly accurate and valuable in the recognition of metastatic and locally recurrent MPNST.

Original languageEnglish (US)
Pages (from-to)334-341
Number of pages8
JournalCancer cytopathology
Volume120
Issue number5
DOIs
StatePublished - Oct 25 2012

Fingerprint

Neurilemmoma
Fine Needle Biopsy
Sarcoma
Cell Biology
Neoplasms
Surgical Pathology
Neurofibromatosis 1
Diagnostic Errors
Pelvis
Melanoma
Neck
Extremities
Head

Keywords

  • Epithelioid
  • Fine-needle aspiration biopsy
  • Malignant peripheral nerve sheath tumor
  • Sarcoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The cytopathology of malignant peripheral nerve sheath tumor. / Wakely, Paul E.; Ali, Syed Z.; Bishop, Justin A.

In: Cancer cytopathology, Vol. 120, No. 5, 25.10.2012, p. 334-341.

Research output: Contribution to journalArticle

Wakely, Paul E. ; Ali, Syed Z. ; Bishop, Justin A. / The cytopathology of malignant peripheral nerve sheath tumor. In: Cancer cytopathology. 2012 ; Vol. 120, No. 5. pp. 334-341.
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