Diagnostic accuracy of fine needle aspiration cytology in soft tissue tumors: our institutional experience

Hemali J. Tailor, Vasudha M. Bhagat, Kumar Bhargav R. Kaptan, Sonal L. Italiya, Hasmukh R. Balar, Manik P. Agarwal


Background: Diagnosis of Soft tissue tumors by FNAC (Fine needle aspiration cytology) is one of the diagnostic modality of choice in pathological evaluation of soft tissue neoplasms especially to differentiate from the non-neoplastic soft tissue lesions. It is challenging and controversial. Very few centers rely on simple FNAC for diagnosis which is largely due to a lack of experience, familiarity, confidence and tricky cytological features.

Methods:We have studied 140 cases of soft-tissue tumors by simple FNAC procedure done by cytopathologist from 01/01/2012 to 31/12/2012. After considering thorough history, clinical, radiology and other findings all cases were reported by the experienced faculty in cytopathology section of our institute.

Results:Out of total 140 cases of soft tissue tumors 131 (93.58%) were benign and 9 (6.42%) were malignant. In benign category maximum numbers were lipoma 105 cases (80.15%) followed by benign neural tumors 5 cases (3.82%), ganglion 4 cases (3.05%), benign fibrohistiocytic lesions 2 cases (1.53%) and others.

Conclusions: Current study demonstrates that FNAC is valuable as a primary tool in diagnosing soft tissue tumors specifically benign lesions like lipomatous tumors, high grade malignant sarcoma and recurrent lesions. Findings are well supported by histopathological correlation.


FNAC, Soft tissue tumors, Diagnostic accuracy

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Simon MA, Finn HA. Diagnostic strategy for bone and soft tissue tumors: J Bone and Joint Surg 1993; 75-A: 622–31.

Silverman JF, West RE, Larkin EW, Park HM, Finley JL, Swanson MS, et al: The role of FNAC in the rapid diagnosis and management of thyroid neoplasm: Cancer. 1986; 57: 1164-1170.

Kini U, Buch A, Bantwal G:Role of FNA in the medical management of minimally enlarged thyroid: Diagn Cytopathol 2006; 34:196-200.

Paul E. Wakely Jr. M.D, Jeffrey S. Kneisl M.D.: Soft Tissue Aspiration Cytopathology Diagnostic Accuracy and Limitations: American Cancer Society meeting 2000; 90 (5):292-298.

Kilpatrick SE, Geisinger KR.: Soft tissue sarcomas: the usefulness and limitations of fine-needle aspiration biopsy:Am J Clin Pathol 1998; 110:50–68.

Fletcher CD, Young AE : Fine needle aspiration cytology of soft tissue tumors:Br J Surg 1987; 74:965-968.

Akerman M, Rydholm A, Persson BM: Aspiration cytology of soft tissue tumors: the 10 year experience at an orthopedic oncology center: Acta Orthop Scand 985;56:407–12.

Skoog L Pereira ST, Tani E: Fine-needle aspiration cytology & immunocytochemistry of soft-tissue tumors and osteo/ chondrosarcomas of the head and neck. Diagn Cytopathol 1999;20:131–6.

Trovik CS, Bauer HCF, Brosjo, Skoog L, Soderlund V: Fine needle aspiration (FNA) cytology in the diagnosis of recurrent soft tissue sarcoma.: Cytopathology 1998;9:320–8.

Kilpatrick SE, Ward WG, Cappellari JO.: Fine-needle aspiration biopsy of soft tissue sarcomas:. Am J Clin Pathol 1999;112:179–88.

Wakely PE Jr, Powers CN, Frable WJ: Metachronous soft tissue masses in children and young adults with cancer: correlation of histology & aspiration cytology:Hum Pathol 1990; 21: 669–77.

Bennert KW, Abdul-Karim FW: Fine needle aspiration cytology vs. needle core biopsy of soft tissue tumors: a comparison. Acta Cytol 1994; 38:381–4.

Costa MJ, Campman SC, Davis RL, Howell LP:Fine-needle aspiration cytology of sarcoma: retrospective review of diagnostic utility and specificity: Diagn Cytopathol 1996; 15:23–32.

Miralles TG, Gosalbez F, Menendez P, Astudillo A, Torre C, Buesa J: Fine needle aspiration cytology of soft-tissue lesions: Acta Cytol 1986;30:671–8.

Willen H, Akerman M, Carlen B: Fine needle aspiration (FNA) in the diagnosis of soft tissue tumours: a review of 22 years experience. Cytopathology 1995; 6:236–47.

Layfield LJ, Anders KH, Glasgow BJ, Mirra JM: Fine-needle aspiration of primary soft tissue lesions: Arch Pathol Lab Med 1986; 110:420–4.

Roy S, Manna AK, Pathak S, Guha D: Evaluation of Fine Needle Aspiration Cytology and Its Correlation with Histopathological Findings in Soft Tissue Tumours: J of Cytol 2007; 24 (1) : 37-40.

Walid E. Khalbuss, Lisa A. Teot, Sara E. Monaco. Diagnostic Accuracy and Limitations of Fine-Needle Aspiration Cytology of Bone and Soft Tissue Lesions; A Review of 1114 Cases With Cytological-Histological Correlation: cancer Cytopathology; Feb 2010.

Roy S, Manna AK, Pathak S, Guha D: Evaluation of Fine Needle Aspiration Cytology and Its Correlation with Histopathological Findings in Soft Tissue Tumours. J of Cytol 2007; 24 (1) : 37-40.

Bharat Rekhi, Biru D Gorad, Anagha C Kakade, RF Chinoy: Scope of FNAC in the diagnosis of soft tissue tumors-A study from a tertiary cancer referral center in India. Cyto Journal 2007;4:20.

Scott E. Kilpatrick, James O. Cappellari, Gary D. Bos, Stuart H. Gold, William G. Ward. 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.

William G. Ward, Paul Savage, Carol A. Boles, Scott E. Kilpatrick. Fine-Needle Aspiration Biopsy of Sarcomas and Related Tumors: Cancer Control; May/June 2001, 8(3).

Hal E. Palmer, Perkins Mukunyadzi ,Wanda Culbreth C.T. (A.S.C.P.), James R. Thomas: Sub grouping and grading of soft-tissue sarcomas by fine-needle aspiration cytology: A histopathologic correlation study: Diag Cytopathol; May 2001, 24(5), 307–316.

Kulkarni RD, et al. Fine needle aspiration cytology of soft tissue tumors in correlation with histopathology. Indian J Pathol Microbiol. 2002;45(1):45-48.