1. ¹Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA
2. ²Department of Pathology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
3. ³Department of Pediatrics, Section of Medical Genetics, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA

Correspondence: Dr SE Kilpatrick, MD, Pathologists Diagnostic Services, Forsyth Medical Center, 3333 Silas Creek Parkway, Winston-Salem, NC 27103, USA. E-mail: sekilpatrick@novanthealth.org

Received 17 November 2005; Revised 9 January 2006; Accepted 10 January 2006; Published online 24 March 2006.

Abstract

Conventional cytogenetic analysis performed from open biopsy tissue samples may be a useful adjunct for the histologic subtyping of bone and soft tissue sarcomas. However, its diagnostic utility in fine needle aspiration biopsy (FNAB) specimens is unclear. We retrospectively reviewed 24 consecutive FNAB bone and soft tissue sarcoma specimens, procured from 1995 to 2003, in which aspirated material was obtained for cytogenetic analysis. The study sample included eight Ewing sarcomas, six synovial sarcomas, five rhabdomyosarcomas, two myxoid liposarcomas, and one each of myxoid chondrosarcoma, osteosarcoma, and atypical lipoma. Cytogenetic analysis confirmed the t(X;18) in all six synovial sarcomas and the t(11;22) in three Ewing sarcomas. The t(2;13) was strongly suggested in one alveolar rhabdomyosarcoma. For two of these cases (both of which were synovial sarcomas), cytogenetic analysis was necessary for definitive diagnosis. While the positive cytogenetic results were supportive in the remainder, all were initially and accurately subtyped based on cytomorphology and/or immunohistochemistry. Cytogenetic analysis was noncontributory (eg no growth) in 14 sarcoma cases, but excluding the case of atypical lipoma, this did not preclude the rendering of an accurate diagnosis. Cytogenetic analysis can be performed on FNAB specimens from bone and soft tissue sarcomas and may be a useful diagnostic aid in difficult cases. However, when cell block material is available for immunohistochemistry, the majority of such cases are successfully subtyped.