Pulmonary spindle cell lesions: correlation of aspiration cytopathology and histopathology

Spindle cell lesions primary to the lung are uncommon. They encompass a range of entities that are sometimes benign, but more often represent malignancies. The cytopathology of these lesions, obtained using fine-needle aspiration biopsy, remain incompletely described. Correlation of fine-needle aspiration smears with tissue sections show relatively faithful reproduction between the two. The overlapping features seen in tissue preparations of these various lesions, however, appears to be magnified in aspirates such that specific diagnoses are less often possible in the latter without immunophenotyping, and occasionally distinction between benign and malignant lesions may be difficult. This review seeks to correlate the salient cyto- and histo-morphologic features of spindled pulmonary lesions, and to cite the limitations and advantages of aspiration cytopathology in analysis of these lesions.