A Correlative Study on Spindle Cell Sarcoma with Cyto-histological Grading by Conventional Methods in an Indian Tertiary Care Teaching Hospital

Objective: Spindle cell sarcomas constitute an important component of soft tissue sarcomas, where accurate grading is more important than histologic subtypes to plan treatment strategies and determine prognosis. To assess whether histologic criteria for grading sarcomas could be applied to fine needle aspiration biopsy (FNAB) specimens of adult spindle cell sarcomas without knowledge of sarcoma subtypes. Furthermore, correlate this grading with histologic Federation Nationale Des Centres de lutte contre le cancer (FNCLCC) grading system and find out the percentage of accuracy of FNAB grading. Methods: Hundred cases were studied by fine needle aspiration cytology (FNAC), among them 50 cases found to be spindle cell sarcoma; in only 42 cases surgical specimens were available. Each aspiration being spread into two or more slides. Subsequently, biopsy was done and studied. Technique used grading of FNAB specimens and corresponding surgical specimens. Result: Grading of FNAB specimens done taking into account four parameters nuclear atypia, nuclear variation (nuclear contour, chromatin, nucleoli, and nuclear overlap), mitotic figure, and necrosis. Grading of surgical specimens done by FNCLCC system. The overall results were correlated for both FNAC and biopsy concordance and statistically analyzed. From there the sensitivity and specificity were calculated as 95.23% and 80.76%, respectively. Conclusion: Histologic criteria for grading sarcomas in adults could be applied to FNAC specimens of spindle cell sarcomas with 88% accuracy. While comparing the diagnosis given by FNAC and biopsy, it revealed the true positive were 40 cases, true negative 42 cases, false positive 10 cases, and false negative (FN) 2 cases.