Preoperative cytological diagnosis of gastric leiomyosarcoma. A report of three cases.

Gastric leiomyosarcoma has rarely been diagnosed prior to operation. Three cases are presented in which a cytological diagnosis compatible with leiomyosarcoma could be made preoperatively by exfoliative cytology using a brushing technique under direct vision. Data which favor the diagnosis of leiomyosarcoma are: (1) spindle-shaped cells with malignant looking nuclei; (2) cells with extremely long, fiber-like cytoplasms and hyperchromatic nuclei; (3) large, anaplastic malignant cells. Smears from 3 patients showed a mixture of these different cell types. This cytological presentation is probably unique and diagnostic for leiomyosarcoma.