The complex cytological features of synovial sarcoma in fine needle aspirates, an analysis of four illustrative cases

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Objective: The cytological features of conventional monophasic spindle cell and biphasic synovial sarcoma have been defined in detail in several large series. The cytology of rare morphological variants, especially the subtypes of poorly differentiated synovial sarcoma, are insufficiently evaluated and diagnostically difficult to define. The objective of the present study was to call attention to the variable cytology of rare variants of synovial sarcoma. Furthermore, adjunctive diagnostic methods, necessary for a correct diagnosis, are discussed. Methods: Aspirates from four synovial sarcomas, with cytological features, which differed from those of conventional synovial sarcoma and from each other, were retrieved from our files and re-evaluated. Results: In three of the cases a correct diagnosis was not obtained from routinely stained aspirates. In the fourth case, the correct diagnosis was established by a combination of cytomorphology, immunocytochemistry and fluorescence in situ hybridization (FISH) performed on the aspirated material. Conclusion: Ancillary diagnostic methods are necessary in the examination of aspiration smears from synovial sarcoma, especially of morphological variants with a cytomorphology that differs from conventional spindle-cell monophasic and biphasic tumours. Immunocytochemistry and molecular genetic examinations (reverse transcriptase polymerase chain reaction or FISH) are the methods of choice.


  • Måns Åkerman
  • Henryk Domanski
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cell and Molecular Biology


  • block, immunohistochemistry, fine needle aspiration, synovial sarcoma, cytology, cytodiagnosis cell, molecular genetics synovial sarcoma, fine, needle aspiration, cytodiagnosis cell block, molecular genetics
Original languageEnglish
Pages (from-to)234-240
Issue number4
Publication statusPublished - 2007
Publication categoryResearch

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000)

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