251. Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum.
- Author
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Wakely PE Jr
- Subjects
- Humans, Male, Female, Adolescent, Young Adult, Adult, Middle Aged, Aged, Aged, 80 and over, Biopsy, Fine-Needle, Ganglioneuroma, Nerve Sheath Neoplasms diagnosis, Nerve Sheath Neoplasms pathology, Nerve Sheath Neoplasms surgery, Neurilemmoma diagnosis, Neurilemmoma metabolism, Neurilemmoma pathology, Soft Tissue Neoplasms, Sarcoma diagnosis
- Abstract
Introduction: Benign peripheral nerve tumors (BPNTs) are a heterogenous group of soft tissue tumors that include a variety of nerve sheath tumors, granular cell tumor (GCT), and ganglioneuroma. Only a few large studies exist on cytopathology and diagnostic accuracy using fine-needle aspiration (FNA) biopsy for this set of neoplasms., Materials and Methods: Both surgical and cytopathology files were searched for cases of BPNT. FNA biopsy was performed using standard techniques., Results: Eighty-nine cases from 88 patients (male:female = 1:1; age range: 16-85 years, mean age, 51 years) met inclusion criteria. FNA sites included extremities (58, 65%), head/neck (14, 16%), deep (9, 10%), and trunk (8, 10%). Aspirates were from primary neoplasms in all but one instance. There were 65 schwannomas, seven neurofibromas, seven perineuriomas, seven GCTs, and three ganglioneuromas/neuromas. Aspirates of schwannoma, GCT, neurofibroma (NF), and perineurioma (PN) were correctly diagnosed in 86%, 100%, 29%, and 0% of cases, respectively. Five tumors (6%) were interpreted as either a specific sarcoma or suspicious for sarcoma. Remaining aspirates were classified as spindle cell neoplasm, salivary gland neoplasm, and nondiagnostic. Cytologic features for schwannoma, NF, PN, and ganglioneuroma showed spindle cell-dominant smears arranged mainly in syncytial clusters. GCT aspirates contained a population of epithelioid cells harboring coarsely granular cytoplasm and bare nuclei. Immunohistochemical (IHC) staining in 55 (62%) cases showed S-100 expression in 95%., Conclusion: FNA biopsy coupled with IHC is reliable in correctly classifying schwannoma and GCT, but less so for NF. Perineurioma can be mistaken for sarcoma., (© 2023 American Cancer Society.)
- Published
- 2023
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