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Fine-needle aspiration of primary and recurrent benign fibrous
histiocytoma: classic, aneurysmal, and myxoid variants.
Diagn Cytopathol.
2004 Dec;31(6):387-91.
There is a
limited number of correlative cytopathological studies of fibrous
histiocytoma (FHC). To better define cytopathological criteria of
diagnosis, we have reviewed fine-needle aspirates (FNA) from 36 FHCs
(32 classical, 1 myxoid, and 3 aneurysmal variants on corresponding
histological sections). Original cytological diagnoses were benign
in 33 (91.7%) cases (22 accurate) and false positive in 3 (8.3%)
cases. All smears were surprisingly homogenous and composed of
histiocytic cells with finely vacuolated cytoplasm in 27 (75%)
cases, small regular spindle cells in 25 (69%) cases, and giant
cells in 17 (47%) cases. Histiocytic cells were attached to vascular
structures in 9 (25%) cases. Slight cytonuclear atypia was seen in
five (14%) cases. Three (8.3%) cases showed numerous siderophages.
In two (5.6%) cases, there were abundant inflammatory backgrounds
and in one (3%) case there was a scant myxoid background. Storiform
patterns, round cells, prominent atypia, necroses, or mitotic
figures were not seen. FHC should be differentiated from other
benign, low- and intermediate-grade spindle-cell neoplasms such as
low-grade fibrosarcoma, dermatofibrosarcoma protuberans, nodular
fasciitis, spindle-cell malignant melanoma, and monophasic synovial
sarcoma. Some cases may be misinterpreted as malignant, especially
in cases of recurrence or in patients with a cancer history.
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