RESUMEN
Myxoinflammatory fibroblastic sarcoma (MIFS) is a low-grade sarcoma generally arising in adults. We present a case of MIFS in a 5-year-old boy with a palpable nodule in the subcutaneous tissue of the scalp. We carried out a literature review to evaluate the diagnostic patterns based on histologic and cytologic features and possible pitfalls and misdiagnoses. A systematic search for articles of interest published between 1995 and 2011 was performed in MEDLINE and PubMed using the words "myxoinflammatory fibroblastic sarcoma," "myxohyaline tumor," and "inflammatory myxoid tumor." Histology and cytology have a pivotal role in the differential diagnosis between MIFS and other potential soft-tissue mimics, such as nodular and proliferative fasciitis and inflammatory myofibroblastic tumor. Fine-needle aspiration cytology is a safe and useful tool for the diagnosis of pediatric patients with MIFS and is important for an accurate and precise preoperative workup to optimize subsequent management and treatment.
Asunto(s)
Fibrosarcoma/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico , Cuero Cabelludo/patología , Neoplasias Cutáneas/diagnóstico , Biomarcadores de Tumor/análisis , Biopsia con Aguja Fina , Preescolar , Diagnóstico Diferencial , Fascitis/diagnóstico , Fibrosarcoma/metabolismo , Granuloma de Células Plasmáticas/diagnóstico , Neoplasias de Cabeza y Cuello/metabolismo , Humanos , Inmunohistoquímica , Masculino , Cuero Cabelludo/metabolismo , Neoplasias Cutáneas/metabolismoRESUMEN
BACKGROUND: In pediatric patients, a cutaneous nodule is usually diagnosed by performing an excisional biopsy, but fine-needle cytology (FNC) is a safer and noninvasive diagnostic method widely used to obtain diagnostic specimens with little stress to the patient. The authors compared the ability of FNC and biopsy to differentiate Langerhans cell histiocytosis (LCH) from juvenile xanthogranuloma (JXG). METHODS: Correlating cytological results with histological findings, the authors reviewed 27 patients (15 males and 12 females; mean age, 37 months; range, 1 month to 14 years) admitted to the University of Padua Department of Pediatrics from 1998 to 2010. RESULTS: Cytology smears were adequate in all 27 (100%) patients: 14 (52%) were classified as having JXG, 12 (44%) as having LCH, and 1 (4%) as having a doubtful finding. A biopsy was also performed in 20 of these patients, and in all but 1, the 2 methods were completely concordant. CONCLUSIONS: FNC is safe and useful in the diagnostic workup of pediatric patients with cutaneous nodules and has no contraindications to its use as the initial diagnostic procedure.