Pitfalls in the Cytological Diagnosis of Nodular Fasciitis: A report of two cases.

Nodular fasciitis (NF) is a benign tumor that is often misdiagnosed due to its rapid growth potential. There are limited case reports highlighting the cytomorphological features of this entity. We present two cases of nodular fasciitis that posed diagnostic challenges. The main features on cytological smears included bland, round to ovoid cells with indistinct cytoplasmic processes with focal cytologic atypia in a background of focal myxoid change. There was no mitosis or necrosis. One of the cases was clinically suspected to be a pleomorphic adenoma while the other was provisionally diagnosed as a pleomorphic sarcoma on FNAC (Fine needle aspiration cytology). It is important to rule out nodular fasciitis on FNAC smears in the era of pre-operative chemo-radiotherapy. Misdiagnosis can result in unnecessary aggressive management.