Letters to Editor

hybridization on fine‑needle aspiration cytology samples of breast Access this article online
cancers: Methodological issues. Diagn Cytopathol 2016;44:1128‑9.
Quick Response Code:
5. Sabour S. Spinal instability neoplastic scale: Methodologic issues to
Website:
avoid misinterpretation. AJR Am J Roentgenol 2015;204:W493. www.jcytol.org
6. Sabour S, Dastjerdi EV. Reliability of four different computerized
cephalometric analysis programs: A methodological error. Eur J Orthod
2013;35:848. DOI:
10.4103/JOC.JOC_44_18
Downloaded from http://journals.lww.com/jocy by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW

How to cite this article: Naderi M, Sabour S. Reproducibility of the

Bethesda system for reporting thyroid cytopathology: A methodological
This is an open access journal, and articles are distributed under the terms of the Creative issue. J Cytol 2019;36:185-6.
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 06/18/2024

Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix,

© 2019 Journal of Cytology | Indian Academy of Cytologists | Published by Wolters Kluwer
tweak, and build upon the work non-commercially, as long as appropriate credit is given and
- Medknow
the new creations are licensed under the identical terms.

Letter to Editor

Solitary Fibrous Tumor of the Tongue: Cytopathologic Fine

Needle Aspiration Findings
Sir, Histological sections showed a well circumscribed and variably
We read with great interest the article by Krishnamurthy on cellular tumor composed of spindle cells intimately admixed
solitary fibrous tumor (SFT) of the orbit.[1] We fully agree with collagenous stroma in a haphazard pattern and mingled
that SFT represents a significant diagnostic challenge for the with staghorn blood vessels [Figure 2]. The tumor cells
cytopathologists. Although SFT may arise at any site,[2] only displayed strong immunoreactivity with vimentin, CD34 and
17 cases of tongue SFT have been reported so far[3] and a review bcl‑2. A diagnosis of SFT was made. It has been no recurrence
of the literature failed to reveal cytology‑based reports of this or metastasis in at least 6 years.
entity. Herein, we present the first report describing the fine
Oral SFT is an unusual finding,[4] especially in the tongue,
needle aspiration (FNA) cytologic findings in a SFT arising in
where only 17 cases have hitherto been reported.[3] Its
the tongue, whose precise diagnosis was based on histologic
cytological picture is not different to that of SFT at other
and immunohistochemical features.
sites and it has been described by others.[4,5] However,
A 26‑year‑old woman presented with a rapidly enlarging diagnosis of SFT based purely on cytomorphology is difficult
lump in the tongue during the last 3 months. On examination, a because of the overlap with reactive lesions and various soft
5 mm, well defined, firm and not‑ulcerated submucosal nodule tissue tumors. Moreover, salivary gland tumors, especially
was noted in the apex of the tongue. FNA of the nodule yielded pleomorphic adenoma and spindle cell myoepithelioma, must
two moderate cellular smears with a bloody background, be included in the differential diagnosis in the lingual location.
containing spindly and plump cells arranged predominantly Immunoreactivity to CD34, CD99 and bcl‑2 is helpful in
in a fascicular pattern and embedded in a matrix [Figure 1]. suggesting the diagnosis of SFT on smears.[5] In the present
Rounded clusters of cells in a cylindromatous‑like fashion were case, we had no enough material for immunocytochemistry
also seen. The tumor cells had oval‑ to spindle‑shaped nuclei analysis, but, in fairness, we must admit that we did not include
with bland chromatin and frequently they had a wavy elongated SFT within our differential diagnosis of the lesion.
pale staining cytoplasm. Some delicate capillary channels
In conclusion, though rare, lingual SFT should considered
were identified within tissue fragments and scattered thick
in the differential diagnosis of a tongue nodule whose FNA
blood vessels were noted in the background. None, amorphous
cytological smears contain spindle cells interspersed with
extracellular hyaline matrix, chondromyxoid component,
collagen.
plasmacytoid or myoepithelial cells were evidenced. No
material for immunocytochemistry analysis of the lesion was Declaration of patient consent
available; hence, a non‑specific FNA diagnosis of benign The authors certify that they have obtained all appropriate
spindle cell proliferation was rendered. Surgical excision of patient consent forms. In the form the patient(s) has/have
the tumor was performed without cervical nodal dissection. given his/her/their consent for his/her/their images and other

186 Journal of Cytology ¦ Volume 36 ¦ Issue 3 ¦ July-September 2019

 Letters to Editor
Downloaded from http://journals.lww.com/jocy by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AW
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 06/18/2024

Figure 1: Spindle cells with regular and ovoid nuclei and wavy elongated Figure 2: Resection specimen showing fascicles of spindled cells in a
cytoplasm, embedded in a wispy and focally dense (arrowhead) matrix whorled configuration around staghorn vessels (hematoxylin and eosin,
containing a delicate and branched capillary channel (small arrows) ×400). Inset: tumor cells are CD34 positive
(Papanicolaou stain, ×400). Upper left inside: spherical cluster of cells
reminding a cylindromatous structure. Lower right inset: a thick and Press; 2010. p. 335.
twisted blood vessel 3. Dungarwalla MM, Barrett AW, Gulati A. Solitary fibrous tumour of the
tongue: A series of four cases. J Laryngol Otol 2017;131:838‑41.
4. O’Regan EM, Vanguri V, Allen CM, Eversole LR, Wright JM, Woo SB,
clinical information to be reported in the journal. The patients et al. Solitary fibrous tumor of the oral cavity: Clinicopathologic
understand that their names and initials will not be published and immunohistochemical study of 21 cases. Head Neck Pathol
and due efforts will be made to conceal their identity, but 2009;3:106‑15.
anonymity cannot be guaranteed. 5. Gupta N, Barwad A, Katamuthu K, Rajwanshi A, Radotra BD,
Nijhawan R, et al. Solitary fibrous tumour: A diagnostic challenge for
Financial support and sponsorship the cytopathologist. Cytopathology 2012;23:250‑5.
Nil.
Conflicts of interest This is an open access journal, and articles are distributed under the terms of the Creative
Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix,
There are no conflicts of interest. tweak, and build upon the work non-commercially, as long as appropriate credit is given and
the new creations are licensed under the identical terms.
Ignacio Galed‑Placed, Laura López‑Solache, Ana Reguera‑Arias
Department of Pathology, A Coruña University Hospital Complex, Access this article online
A Coruña, Spain Quick Response Code:
Website:
Address for correspondence: Dr. Ignacio Galed‑Placed, www.jcytol.org
Servicio de Anatomía Patológica, Complejo Hospitalario Universitario
A Coruña, A Coruña, Spain.
E‑mail: [email protected] DOI:
10.4103/JOC.JOC_78_18

References
1. Krishnamurthy V, Suchitha S, Asha M, Manjunath GV. Fine needle How to cite this article: Galed-Placed I, Lopez-Solache L, Reguera-Arias A.
aspiration cytology of solitary fibrous tumor of the orbit. J Cytol Solitary fibrous tumor of the tongue: Cytopathologic fine needle aspiration
2017;34:104‑6. findings. J Cytol 2019;36:186-7.
2. Markku M, editor. Solitary fibrous tumor, hemangiopericytoma, and
© 2019 Journal of Cytology | Indian Academy of Cytologists | Published by Wolters Kluwer
related tumors. In: Modern Soft Tissue Pathology: Tumours and
- Medknow
Non‑Neoplastic Conditions. Ch. 12. New York: Cambridge University

Journal of Cytology ¦ Volume 36 ¦ Issue 3 ¦ July-September 2019 187