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The Cytology of Soft Tissue Tumours (Monographs in Clinical Cytology)

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The cytological diagnosis of soft tissue tumours, based on fine needle aspirates, has been debated and at times dis couraged except in the diagnosis of lipoma. Soft tissue tumours are relatively rare in spite of the fact that more than 100 benign subtypes, over 50 variants of sarcoma and a number of 'border-line' entities have been described. Individual cytopathologists are thus not likely to encounter many of the less common variants of soft tissue tumours during their training and may only occasionally needle them in their later practice. It has been strongly recommended that the primary morphological diagnosis of malignant soft tissue tumours as well as other investigations and treatment should be performed at multidisciplinary centres. In prac tice, however, it is not possible to refer all patients with soft tissue tumours to a musculoskeletal tumour centre for pri mary work-up. Tumours are usually considered to be suspi cious if they are large (>5cm) or deep-seated (inter-or intramuscular). This implies that the management of the majority of soft tissue tumours is undertaken in general hospitals.

In the last few years, the primary diagnosis of soft tissue tumours has emerged as an important new target for fine needle aspiration (FNA). The purpose of this book is to facilitate the cytological evaluation of FNA smears from soft tissue tumours and to suggest cytological criteria for histotype diagnoses. Its primary aim is to describe and illustrate not only the most common types but also those rare tumours where cytological features have been largely described in case reports and in small series. The diagnostic use of ancillary methods is discussed and illustrated, and, in order to facilitate the diagnostic work-up in FNA samples, smears are also classified according to their principal microscopic patterns. The selection of entities presented, their diagnostic features and differential diagnostic considerations are mainly based on the experience with FNA in the primary diagnosis of soft tissue tumours in patients referred to the Musculoskeletal Tumour Centre.

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