Fine-needle aspiration cytology of malignant peripheral nerve sheath tumors

The histopathologic features of malignant peripheral nerve sheath tumors (MPNSTs) have been well described. There have been limited studies on the cytologic features of MPNST. In this present study, we have retrospectively reviewed eight histopathology confirmed cases of MPNST over a 5-year period. Detailed cytomorphological analysis of these cases was carried out individually by two observers. On cytology, these cases were diagnosed as benign spindle-cell tumor (two), spindle-cell tumor possibly benign (one), spindle-cell tumor possibly malignant (one), malignant spindle-cell tumor (two), spindle-cell tumor, and neural origin (two). The cardinal cytomorphologic features were loosely cohesive clusters and fascicular arrangement of spindle cells with rounded ends. The kinking of nuclei was not a conspicuous finding. Fibrillary background was noted in two of the cases. Nuclear pleomorphism was ranged from mild to moderate degree. One case exhibited extensive intranuclear pseudoinclusions. Mitotic figures (including atypical forms) were present in almost all the cases. Possibly a constellation of cytologic features such as clusters of short and long fascicles of cells admixed with dissociated spindle cells of round-ended nuclei and prominent nucleoli on myxoid or fibrillary background and frequent mitosis may be helpful in diagnosis of MPNSTs. The cytomorphologic features along with clinical correlation are necessary to increase the diagnostic accuracy of MPNST on aspiration cytology.