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The cytopathology of
soft tissue mxyomas: ganglia, juxta-articular myxoid lesions, and
intramuscular myxoma.
We studied the
practicality of issuing a cytologic diagnosis of myxoma/juxta-articular
myxoid lesion/ganglion (MJG) by reviewing all fine-needle aspiration (FNA)
biopsy specimens of soft tissue masses in our files with diagnoses of
myxoma, myxoid cyst, myxoid lesion, ganglion, or ganglion cyst. The
control group was soft tissue aspirates with abundant myxoid stroma.
Of 39 cases with a cytologic diagnosis of soft tissue MJG, 15 had
subsequent tissue biopsy or complete resection of the mass; 24 had
clinicoradiologic follow-up. All cases except 1 (fat necrosis) were
diagnosed correctly as benign myxoid lesions. We grouped MJG aspirates
into 3 subtypes based on clinicoradiologic features: soft tissue
ganglion/ganglion cyst (12 cases), juxta-articular myxoid lesion (16
cases), and intramuscular myxoma (11 cases). MJG aspirates showed few,
subtle cytopathologic differences among subtypes. They
characteristically had a viscous, gelatinous quality when expressed
from the needle onto the glass slide. The typical smear contained a
film of paucicellular, often finely granular, myxoid stroma, that
contained few cells, usually macrophages or bland spindle cells.
Control group aspirates always contained cellular components that
allowed distinction from MJGs. The cytopathologic diagnosis of MJG
lesions is accurate; FNA biopsy can be used to subtype MJGs into 3
categories when clinicoradiologic features are known. |