Ae1ae3 and ema, on the spindle cell component, can be useful in the differential diagnosis of spindle cell carcinoma spcc with other sarcomatous lesions. Despite their varied histogenesis and behaviour, some lesions show an overlap of morphological features, making accurate diagnosis a challenging task, particularly in needle. Benign and lowgrade spindle cell tumors basicmedical key. No specific marker exists to confirm the diagnosis other than excluding other entities. Ame is a epithelialmyoepithelial tumour, composed of myoepithelial cells surrounding epithelium lined spaces. The approach used for the diagnosis of these tumors should be based on knowledge of the relative frequencies of different tumor types, appropriate consideration of clinical context, and correct interpretation of histologic features. The workup of spindle cell lesions of the breast requires the judicious use of immunohistochemical stains to arrive at the correct diagnosis, especially on coreneedle biopsy. Gastrointestinal tract spindle cell lesionsjust like real.
Spindle cell hemangioendothelioma mdedge dermatology. In monophasic lesions with pure bland spindle cells only, the possible lesions include fibromatosis, fibromatosis like metaplastic carcinoma and other unusual conditions like. An important point to mention is the high rate of recurrence of this tumor. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindleshaped when examined under a microscope. An approach to the diagnosis of spindle cell lesions of. Less common lesions are inflammatory myofibroblastic tumours, the mesenteric spindle cell reactive lesions, retroperitoneal fibrosis, and solitary fibrous tumour. It is important to increase the recognition of the disease and improve the level of clinical diagnosis. The material was culled from 12,000 autopsy protocols covering the years since 1900 and from 5,3 records of gastrointestinal tumors. Spindle cell sarcoma can affect any age group, but is most common in people over the age of 40. Other spindle cell tumors may occasionally show highlevel expression of tle1 such as peripheral nerve sheath tumors. A total of 157 cases, including 14 afxs, 5 spindle cell squamous cell carcinomas sccs, and 7 spindle cell desmoplastic melanomas, along with other cutaneous spindle cell and histiocytic fibrohistiocytic lesions. Pdf primary spindle cell lesions of the thyroid gland an.
Diagnosis we will confirm your diagnosis once we have carried out xrays, ultrasound and mri scans imaging and have the histology results from the biopsy taken from the tumour. Spindle cell squamous cell carcinoma of skin may appear as skin lesions, commonly on sunexposed areas, mostly the head and neck region. It starts with just a small lump and inflammation and then the symptoms slowly progress as the cancer grows. Spindle cell lesions of the urinary bladder eosinophilic cytoplasmic processes set in a background which was described as loose and edematous, or myxoid, and contained inflammatory cells and slender blood vessels. Accurate diagnosis on percutaneous core biopsy within this category is essential as some lesions require excision and surveillance, whereas others may be observed.
Take home messages always consider and exclude metaplastic or spindle cell carcinoma always consider the possibility of a phyllodes tumor immunostains are frequently needed to evaluate spindle cell tumors on core needle biopsy definitive classification of a spindle cell tumor on. Cd163 has been shown to have great specificity for tumors. Spindle cell lesions of the breast university of utah. The lack of mdm2 immunopositivity or 12q15 amplification in this tumor type suggests spindle cell liposarcoma represents a separate group. Prostatic spindle cell lesions are diagnostically challenging and encompass a broad array of benign and malignant processes. The other rare lesion of breast with spindle cells is ame. The entities, both benign and malignant, that compose the spindle cell lesions. Tenosynovial giant cell tumors also called nodular tenosynovitis. Refresh and broaden your knowledge of spindle cell lesions help you to establish a histology based approach for classification of spindle cell tumors learn distinctive features of select spindle cell tumors for accurate identification. Benign spindle cell lesions of the breast include neoplastic and reactive entities that are diagnostically challenging given their rarity and similar histomorphology.
Cutaneous and superficial soft tissue spindle cell proliferations with cd34 expression represent a unique heterogeneous group of lesions. Spindle cell scc is a biphasic tumor with both a conventional scc component and a malignant spindle cell component mimicking a mesenchymal malignancy. The study is based on 140 cases of spindle cell tumor of the gastrointestinal tract seen at the massachusetts general hospital. The who classification of tumours of soft tissue and bone. A 4cm lesion was resected from the gastric antrum of a 56yearold woman.
Take home messages always consider and exclude metaplastic or spindle cell carcinoma always consider the possibility of a phyllodes tumor immunostains are frequently needed to evaluate spindle cell tumors on core needle biopsy definitive classification of a spindle cell tumor. Although most breast spindle cell lesions bscls are rare, they constitute a wide spectrum of diseases, ranging from reactive processes to aggressive malignant tumours. The approach used for the diagnosis of these tumors should be based on knowledge of the relative frequencies of different tumor. The spindle cell or sarcomatoid component of this tumor can mimic numerous other reactive, benign, and malignant lesions. Refresh and broaden your knowledge of spindle cell lesions help you to establish a histology based approach for classification of spindle cell tumors learn distinctive features of select spindle cell tumors.
Spindle cell tumors are potentially very serious and even life threatening growths which may develop over the course of your pets lifetime. Spindle cell lipoma is a benign breast lesion that histologically consists of adipocytes, collagen fibers, and uniform spindle cells. They commonly are classified as primary or secondary to metastatic disease. The authors report the diagnosis, management, and outcomes of 6 cases of spindle cell oncocytoma sco in an effort to guide clinical diagnosis and management of these uncommon lesions. Although both luminal epithelial and myoepithelial cells may assume spindle shapes, spindle cell lesions of the breast usually refer to conditions that are composed of mesenchymal or mesenchymallike cells. This lesion is seen adherent to the skeletal muscle upper third of image a and is composed of fascicles of spindle cells b with minimal pleomorphism c. It starts with just a small lump and inflammation and then the symptoms slowly progress as the cancer grows from one stage to another.
Spindle cell lesions are seen frequent enough that one ought to have a solid approach to em. In monophasic lesions with pure bland spindle cells only, the possible lesions include fibromatosis, fibromatosis like metaplastic carcinoma and other unusual conditions like dermatofibrosarcoma protuberance 14. Continuing medical education article diagnostic value of. Spindle cell carcinoma an overview sciencedirect topics. Spindle cell carcinoma of the leg is an unusual tumor.
Tumors composed of benign spindle cells, with variable lines of differentiation first described by toker cancer 1981. A striking feature of this set of acral spindle cell lesions is that the dermal spindle cells stain strongly for cd34 in all cases studied so far. Whereas functional melanocytes reveal a dendritic cytomorphology and territorial isolation, lesional naevomelanocytes and melanoma cells. Spindle cell sarcoma symptoms, prognosis, survival rate. The histologic diagnosis of atypical fibroxanthoma afx can sometimes be challenging. Spindle cell lipoma usually presents as a painless mobile palpable mass 5153. The shape of the cancer cells is spindle and so it is named spindle cell sarcoma. The most common spindle cell lesion presenting along the uadt mucosa is spindle cell carcinoma spcc, which has many unique and challenging clinical and pathologic features.
Melanocytic lesions show great morphological diversity in their architecture and the cytomorphological appearance of their composite cells. Cutaneous spindle cell lesions encompass a heterogeneous group of tumors that range from reactive to benign, borderline, and malignant tumors. Spindle cell lesions of the adult prostate modern pathology. The tumors generally begin in layers of connective tissue. We present three cases of rare benign spindle cell lesions. Step by step approach to rare breast lesions containing. Spindlecell lesions of the breast with emphasis on the. A general introduction to spindle cells is found in the spindle cell article. A spindle cell is a fusiform cell that is tapered at both ends. Spindlecell tumors of the gastrointestinal tract radiology. Pdf diagnostic value of cd163 in cutaneous spindle cell. Spindle cell carcinoma, also termed carcinosarcoma, pseudosarcoma, polypoid carcinoma, sarcomatoid carcinoma, and spindle cell variant of squamous cell carcinoma, is a rare type of malignant tumor that often grows as an exophytic polypoid lesion.
Spindle cell carcinoma of lung is a very rare type of carcinoma that does not contain any differentiated carcinomatous component, but consist only of pure malignant spindle cells according to the who, a definitive diagnosis of the carcinoma can only be made on a surgicallybiopsied tumor. Despite their varied histogenesis and behaviour, some lesions. The spindle cell or sarcomatoid component of this tumor can mimic numerous other reactive, benign, and malignant lesions table 1. Pdf spindle cell lesions of the breast the pathologic. In addition to the variety of lesions, salivary gland tumors with a predominant spindle cell pattern are rare, accounting for less than 3% of salivary gland aspirates. The majority of ovarian spindle cell lesions fall into the broad category of fibromatous neoplasms whereas others in the sex cordstromal group may also be composed of spindle cells, including thecomas, granulosa, and sertolileydig cell tumors and rarer neoplasms, such as sclerosing stromal tumor and signetring stromal tumor. They commonly are classified as primary or secondary. Spindle cell lesions of the thyroid gland tscl are not encountered routinely in clinical practice or in the context of thyroid pathology.
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