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Fine‐needle aspiration biopsy cytology of malignant neoplasms of the sinonasal tract
Author(s) -
Helsel Jay C.,
Bardales Ricardo H.,
Mukunyadzi Perkins
Publication year - 2003
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10956
Subject(s) - medicine , cytology , fine needle aspiration , cytopathology , pathology , biopsy , cancer , maxillary sinus , metastatic carcinoma , mesothelioma , radiology , carcinoma , surgery
BACKGROUND Primary and metastatic malignancies that originate in the sinonasal tract are rare and histologically diverse. The role of fine‐needle aspiration biopsy (FNAB) and the cytomorphologic features of these tumors have not been specifically addressed. METHODS The authors reviewed 22 cytology cases (20 FNABs, 1 sputum sample, and 1 pleural fluid sample) from 18 patients with malignancies originating in the sinonasal tract (17 carcinomas, 3 melanomas, and 2 sarcomas) and assessed the cytomorphology, cytohistologic correlation, and ability of cytology to render a specific diagnosis. RESULTS Primary and metastastic sites sampled by FNAB included masses in or around the nose ( n = 2), orbit (2), maxillary sinus (2), frontal sinus (1), intraoral area (1), preauricular area (1), soft tissue neck masses, parotid and lymph nodes (10), and cervical spine (1). Exfoliative cytology was positive in two samples of sputum and pleural fluid, representing the initial cancer diagnosis before the sinonasal primary tumor was detected. Seventeen of 22 (77.3%) cases were classified as carcinoma not otherwise specified, carcinoma with specific differentiation, sarcoma, or melanoma. Cytology failed to correctly classify the specific subtype of three carcinomas. The cytologic features that were evaluated included cellularity, cellular arrangement, nuclear features, nuclear‐to‐cytoplasmic ratio, and the background appearance. CONCLUSIONS Sinonasal tract malignancies demonstrate a wide range of cytologic findings but specific features allowing for an accurate and definitive diagnosis are often present in many tumors. Fine‐needle aspiration cytology is an important diagnostic tool in the management of sinonasal malignancies and can be complemented by the use of ancillary studies for the diagnosis of poorly differentiated or nonepithelial tumors. Cancer (Cancer Cytopathol) 2003;99:105–12. © 2003 American Cancer Society.