{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T15:04:05Z","timestamp":1782140645386,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnosis of spindle cell neoplasms (SCN) of the upper gastrointestinal (GI) tract, hepatobiliary tract, and pancreas detected by fine needle aspiration (FNA) is challenging. We describe a single\u2010center experience of these samples with follow\u2010up data and characterization of the morphologic findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed pathology records for all FNAs diagnostic for or suggestive of SCN on esophagus, stomach, small bowel, liver, and pancreas in a 15\u2009year period. All cases with at least 6\u2009month follow\u2010up were included. Surgical material (biopsy or resection) was the diagnostic gold standard. All FNAs with subsequent surgical specimens were reviewed and assessed for cellularity, architectural features, and nuclear features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 15\u2009years, 5101 FNAs of the upper GI tract, hepatobiliary tract, and pancreas were performed. SCN was diagnosed in 98 (2%) patients. Seventy\u2010two patients had definitive pathologic diagnoses: 68 were neoplastic and four were non\u2010neoplastic. Cytomorphologic review in relationship to final diagnosis revealed three statistically significant features: low cellularity favors a benign process (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.00544), epithelioid nuclear morphology favors malignancy (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.00278), and identification of perinuclear vacuoles favors a diagnosis of GIST over non\u2010GIST SCN (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04236).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among cases with follow\u2010up, final pathologic diagnoses were SCN in 94% of cases diagnosed as SCN on FNA of upper GI, hepatobiliary tract, and pancreas. Although some cytomorphologic criteria are more suggestive of malignancy, arriving at a specific diagnosis relies on collaboration of clinical, radiologic, cytomorphologic, and immunohistochemical data.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24801","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T13:48:14Z","timestamp":1621345694000},"page":"987-996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Spindle cell neoplasms of the upper gastrointestinal tract, hepatobiliary tract, and pancreas by fine needle aspiration: A single institutional experience of 15\u2009years with follow\u2010up data"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2389-9851","authenticated-orcid":false,"given":"Kelsey E","family":"McHugh","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Robert J Tomsich Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley I","family":"Odronic","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Robert J Tomsich Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Robert J Tomsich Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridgette","family":"Springer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Robert J Tomsich Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada","family":"Aramouni","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Robert J Tomsich Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J","family":"Chute","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Robert J Tomsich Pathology &amp; 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