Fine-Needle Aspiration of Soft Tissue Masses
Fine-Needle Aspiration of Soft Tissue Masses
Multiple myeloma (MM) commonly involves the bone marrow and axial skeleton. Soft tissue masses and plasmacytomas are uncommon but may predate the development of systemic disease. The prognostic significance of plasma cell cytology of soft tissue masses in this disease remains unknown. In the presence of bone marrow involvement, evaluation of soft tissue myeloma masses for prognostic data typically has not been aggressively pursued.
The study presented by Mukunyadzi and colleagues establishes the importance of cytomorphology of soft tissue masses as a prognostic tool. The study suggests that monitoring soft tissue lesions for MM using fine-needle aspiration (FNA) is especially useful in patients whose bone marrow biopsy results were negative. Forty-two percent of patients in this study had no bone marrow involvement. The study authors showed that prognostic staging could be determined reliably through use of FNA of soft tissue masses.
It should be noted that patients with high-grade tumors in soft tissue had a grim prognosis despite having had negative bone marrow biopsy results. Of the 7 patients with blastic MM, 4 (57%) died within the study follow-up period. Among those who died were 2 of the 7 patients with blastic MM who had negative bone marrow biopsy results. Routine FNA of soft tissue masses earlier in the patient's treatment may have staved off disease progression to high-grade status.
Analysis of aspirates of soft tissue masses in myeloma patients is an effective and less expensive procedure to assess prognosis. It may be useful in the routine treatment of patients with MM.
Multiple myeloma (MM) commonly involves the bone marrow and axial skeleton. Soft tissue masses and plasmacytomas are uncommon but may predate the development of systemic disease. The prognostic significance of plasma cell cytology of soft tissue masses in this disease remains unknown. In the presence of bone marrow involvement, evaluation of soft tissue myeloma masses for prognostic data typically has not been aggressively pursued.
The study presented by Mukunyadzi and colleagues establishes the importance of cytomorphology of soft tissue masses as a prognostic tool. The study suggests that monitoring soft tissue lesions for MM using fine-needle aspiration (FNA) is especially useful in patients whose bone marrow biopsy results were negative. Forty-two percent of patients in this study had no bone marrow involvement. The study authors showed that prognostic staging could be determined reliably through use of FNA of soft tissue masses.
It should be noted that patients with high-grade tumors in soft tissue had a grim prognosis despite having had negative bone marrow biopsy results. Of the 7 patients with blastic MM, 4 (57%) died within the study follow-up period. Among those who died were 2 of the 7 patients with blastic MM who had negative bone marrow biopsy results. Routine FNA of soft tissue masses earlier in the patient's treatment may have staved off disease progression to high-grade status.
Analysis of aspirates of soft tissue masses in myeloma patients is an effective and less expensive procedure to assess prognosis. It may be useful in the routine treatment of patients with MM.
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