Cytopathology of myxoinflammatory fibroblastic sarcoma: a series of eight cases and review of the literature

Sintawat Wangsiricharoen, Syed Z. Ali, Paul E. Wakely

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare low-grade sarcoma presenting as a slow-growing mass that occurs mainly in the distal extremities of adults. Relatively little is known about the cytopathology of MIFS. We evaluated cytologic characteristics of MIFS on fine-needle aspiration (FNA). Materials and methods: A search was made of our cytopathology and surgical pathology databases for cases diagnosed as MIFS. FNA biopsy smears and cell-block were performed and examined using standard technique. Results: Eight cases were retrieved from patients aged 22-90 years (mean, 56 years), and M:F ratio of 1:1. Six tumors (75%) were primary, and 2 (25%) locally recurrent. Distal lower limb was involved in all but one case (88%). One (13%) recurrent case was correctly diagnosed cytologically as MIFS; remaining single diagnoses were varied: myxofibrosarcoma, low-grade sarcoma, malignant neoplasm, myxoid neoplasm, atypical fibrohistiocytic neoplasm, atypical cells with chronic inflammation, and spindle cells with atypia. Among 7 cases with available cytologic slides for review, common features were spindle cells with variable atypia (100%), rare virocyte/Reed-Sternberg -like cells (86%), background mixed inflammation (71%), and variable myxoid stroma (57%). Pseudolipoblasts and multinucleated giant cells were rare. Hemosiderin and branching capillaries were largely absent. Immunohistochemistry was non-specific. Conclusion: MIFS was accurately interpreted in only 13% of cases; remaining cases were diagnosed as atypical or malignant, which would lead to proper management. A specific cytologic diagnosis of MIFS using FNA is extremely difficult in our experience due to an absence of distinctive cytomorphology and specific immunophenotype.

Original languageEnglish (US)
JournalJournal of the American Society of Cytopathology
DOIs
StateAccepted/In press - 2021

Keywords

  • Cytopathology
  • Fine needle aspiration
  • Myxoinflammatory fibroblastic sarcoma
  • Sarcoma
  • Soft tissue tumor

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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