Background: The differentiation between myxomas and myxoid liposarcomas (MLPS) often is a serious challenge for the radiologists. Magnetic resonance imaging (MRI) is the most useful imaging technique in characterization of the soft tissue tumors (STT). Purpose: To evaluate in a sample of myxomas and MLPS of the extremities, what morphological findings in conventional MRI allow us to differentiate these two types of myxoid tumors, in addition to analyzing the validity of the apparent diffusion coefficient (ADC) values of diffusion-weighted MRI (DW-MRI). Material and Methods: Magnetic resonance imaging studies in myxomas and MLPS of extremities searched in our PACS between 2015 and 2019. All studies had conventional MRI with T1, T2, and PD SPAIR sequences, while DW-MRI with ADC mapping and perfusion MRI with a T1 sequence repeated for 4 minutes after contrast injection were additional sequences only in some explorations. Two radiologists evaluated independently the MRI studies by examining the qualitative parameters. Apparent diffusion coefficient values were calculated using two methods—ADC global and ADC solid, and Receiver Operating Characteristic (ROC) curves were applied for analysis. Results: The features were consistent with MLPS: size greater than 10 cm, heterogeneous signal on T1, and nodular enhancement, while the common findings for myxomas were a homogenously hypointense signal on T1 and diffuse peritumoral enhancement. The solid and global ADC values were higher in myxomas. We observed that the solid ADC value less than 2.06 x 10 −3 mm 2 x s would support the diagnosis of MLPS against myxoma. Conclusion: Overall, MRI with its different modalities improved the diagnostic accuracy when differentiating myxomas from MLPS of extremities.
Objectives: The hyalinizing trabecular tumor (HTT) is a rare benign neoplasm of the thyroid gland. This neoplasm has overlapping cytological features with Papillary Thyroid Carcinoma, Medullary Carcinoma and Follicular Neoplasm with Nuclear Features of Papillary Carcinoma. This can lead to misdiagnosis of malignancy in fine needle aspiration (FNA) cytology specimens with unnecessary total thyroidectomy. The aim of this study is to determine if there are some cytological features that could help us to suspect HTT on FNA specimens and avoid radical surgery. Material and Methods: With this purpose we have collected 6 cases diagnosed of HTT in Hospital Clínico San Carlos of Madrid (Spain) in the last 10 years and reviewed the cytological specimens. Result: We conclude that the presence of hyaline material in FNA specimens of HTT is a constant feature being a diagnostic clue. We must be cautious not to confuse it with dense colloid or amyloid material, the latter seen in Medullary Carcinoma. Papillary architecture and fibrovascular cores are not present in a HTT. Special stains as ki-67, calcitonin and Congo Red staining could help us in achieving the correct diagnosis. Conclusion: We feel the cytopathologists must be aware of the distinguishing features of this lesion, mainly the typical hyaline material to achieve a proper diagnosis and be able to reduce unnecessary aggressive management of these patients.
Introduction: Pathology requires the integration of macroscopic and microscopic findings for an accurate diagnosis. Fine needle aspiration biopsy (FNA) traditionally became the domain of radiologists with the introduction of ultrasound; however, its increased accessibility has allowed other specialists, including pathologists, to incorporate it into their daily practice. Both ultrasound-guided FNA and core needle biopsy (CNB) performed by interventional pathologists have proven valuable tools in the diagnosis of lymph node lesions. Materials and Methods: An observational, descriptive, retrospective study was conducted at Hospital Universitario del Henares, analysing 134 FNABs and 31 CNBs of lymph node lesions between 2023 and 2024. The diagnostic yield of both techniques and their correlation were evaluated. Results: Ultrasound facilitated better lesion characterization. FNA demonstrated a diagnostic yield of 98%, with a 94% correlation with CNB results. The Sydney system 2020 was applied to FNA reporting in lymphatic node. An equivalent classification system for CNB is proposed. Conclusion: The performance of FNA and CNB by pathologists optimizes diagnosis, reduces time and costs, and strengthens their role in minimally invasive diagnostics. Adoption of a unified classification system for CNB lesions would facilitate communication between specialists.