There is usually no tissue culture-like appearance. The spindle cells show elongated, wavy nuclei. "Mixed endometrial stromal and smooth muscle tumors of the uterus: a clinicopathologic study of 15 cases.". Pigmented Spindle Cell Nevus (Reed) is a benign, darkly-pigmented skin lesion that chiefly forms on the upper and lower limbs. SMA immunohistochemistry shows diffuse cytoplasmic reactivity of the spindle cells. At low power, the lesion bears a superficial similarity to spindle cell lipoma, although it is far more cellular. Remstein, ED. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. This review discusses the main differential diagnoses of an ovarian spindle cell lesion, especially concentrating on the recent literature. A history of previous biopsy is useful in reaching the correct diagnosis. Spindle cells should make think: 1. This type of cancer can occur on nearly any of the onnective tissues of the body, including the stomach, muscles, and lungs. 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 mesenchymal-like cells that harbour elongated and stretched cytoplasm. Spindle epithelial tumor with thymus-like differentiation, Sclerosing extramedullary hematopoetic tumours, Angiolymphoid hyperplasia with eosinophilia, Diffuse-type tenosynovial giant cell tumour, Fasciitis-like reactive myofibroblastic proliferation, Ossifying fibromyxoid tumour of soft parts, Anthracotic & anthracosilicotic spindle cell pseudotumour of mediastinal lymph node, Ossifying desmoplastic nested epithelial-stromal tumour of liver, Mixed endometrial stromal and smooth muscle tumour of the uterus, http://ajp.amjpathol.org/cgi/content/full/160/3/759, https://librepathology.org/w/index.php?title=Spindle_cell_lesions&oldid=47541, superficial cervicovaginal myofibroblastoma, hyalinizing spindle cell tumour with giant rosettes, skeletal muscle and neural differentiation. The tumors generally begin in layers of connective tissue such as that under the skin, between muscles, and surrounding organs, and will generally start as a small lump with inflammation that grows. Spindle cell neoplasms are dened as neoplasms that consist of spindle-shaped cells in the histopathology. 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 mesenchymal-like cells that harbour elongated and stretched cytoplasm. 3. But more extensive lesions may require wide local excision. Spindle cell sarcoma is an uncommon cancerous lesion or tumor that forms in an individual's soft tissues or bone. Spindle Cell Liposarcoma A very rare and unusual form of liposarcoma consisting almost entirely of loosely arranged fibroblast-like spindle cells oriented along a single plane and surrounded by a delicate reticulin meshwork. Gross specimen shows a whitish whorled lesion with both circumscribed and ill-defined margins within the breast parenchyma and involving the chest wall muscle. (Feb 2000). Carcinoma, e.g. "Leydig cell tumors of the testis with unusual features: adipose differentiation, calcification with ossification, and spindle-shaped tumor cells.". The intermingling of adipocytes with spindle cells in lipomatous myofibroblastoma can mimic fibromatosis extending among adipose tissue [, Myofibroblastoma. Fibromatosis can mimic breast malignancy, presenting as an ill-defined mass with spiculations, typically adjacent to or arising from the pectoralis muscle. Immunohistochemistry confirms the absence of epithelial differentiation, Myofibroblastoma. Treatment for spindle cell hemangiomas is often conservative, consisting of simple surgical excision. Several dark nuclei of scattered lymphocytes are present, Nodular fasciitis. Spindle cell hemangioma (hemangioendothelioma) is a distinct vascular lesion which was initially considered to be a low grade angiosarcoma when first described in 1986. 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 hemangioendothelioma. Malignant melanoma. A lobulated appearance resembling a fibroadenoma can be seen. In fibromatosis, there are long, intersecting fascicles of spindle cells in a collagenous background. "Spindle cell liposarcoma, a hitherto unrecognized variant of liposarcoma. Excision biopsy shows the stellate outlines of the lesion at low magnification. High magnification shows slender, elongated, and slightly wavy nuclei with tapered ends. (Nov 2004). Correlation with the radiological appearance is also important, as fibromatosis presents as a stellate lesion or as an architectural distortion on imaging, whereas a fibrous scar is consequent to instrumentation, which may have been performed for other reasons such as calcifications or a mass. Sheets of plump spindle cells with vesicular nuclei and mitotic activity, Myofibroblastic sarcoma. ; Srigley, JR.; Hatzianastassiou, DK. (Feb 2005). "Lipoleiomyosarcoma (well-differentiated liposarcoma with leiomyosarcomatous differentiation): a clinicopathologic study of nine cases including one with dedifferentiation.". Spindle cell lesions of the breast cover a wide spectrum of diseases ranging from reactive tumor-like lesions to high-grade malignant tumors. There can be an association with trauma or breast implants. 2.1. The spindle cells are histologically bland and show smooth muscle differentiation, which may be verified with desmin and smooth muscle markers on immunohistochemistry (Figs. In the histologic assessment …. The tumor usually measures 3 to 5 cm. Hanft, VN. These are considered in Chapters 11 and 13, respectively. Spindle cell lesions can occur in head and neck leading to numerous alternate terms, including carcino- skin, in the soft tissues of the scalp, orbit, and neck, and sarcoma, pseudosarcoma, pleomorphic carcinoma, and along the upper aerodigestive tract (UADT) mucosa. It is also known as a Reed Nevus or a Reed Tumor The nevus appears as a single, flat or raised skin lesion that is well-circumscribed. Fibromatosis is a locally aggressive but non-metastasising lesion composed of fibroblasts and myofibroblasts. Iwasa, Y.; Fletcher, CD. Folpe, AL. How can Spindle Cell Squamous Cell Carcinoma of Skin be Prevented? Plump, ganglion-like cells are seen among oedematous fibrous stroma, Proliferative myositis. Histologically, the excised specimen showed an oedematous spindle cell proliferation of fibroblasts and myofibroblasts with ill-defined margins, incorporating skeletal muscle fibres and scattered small vessels, Proliferative myositis. "Myofibrosarcoma: a clinicopathologic study.". Other. Myoid hamartoma. Fibromatosis of breast. Monomorphic - small variation of tumour cell size. Intra‐abdominal spindle cell lesions are uncommon and often present a diagnostic challenge. With the history of a prior core biopsy, a differential that needs to be excluded is fibrous scarring, but this excision was performed within a week after the core biopsy, and histologically the reparative process would comprise relatively fresh granulation rather than a fibrous-like lesion. Fibrosarcoma is very rare in the breast; when observed, it may be part of a dermatofibrosarcoma with secondary involvement of the breast, or it may be associated with a borderline or malignant phyllodes tumour. Definition. Ropy, pink collagen fibres are seen among the spindle cells with ovoid nuclei. spindle cell A generic term for an elonged and/or fusiform cell, regardless of origin. Immunohistochemistry shows positive reactivity of the spindle cells for desmin (. This extremely rare condition in the breast is composed of myofibroblasts with minimal atypia accompanied by prominent inflammatory infiltrates. A fibrous, whorled appearance with ill-defined borders may be observed on cut sections (Fig. ; McNutt, NS. A low-grade angiosarcoma resembling a … An exuberant tissue response can lead to a nodular spindle lesion referred to as a spindle cell nodule [. It is a rare form of cancer. Nodular fasciitis has a greyish-white, myxoid appearance. PASH is a benign reactive spindle cell lesion most commonly found in premenopausal women, although it can also occur in men with gynecomastia.11 PASH is most often an incidental finding, present microscopically in up to 23% of breast biopsies12 and often omitted from the final diagnosis if more significant pathology is identified. They are usually well circumscribed and based in subcutaneous tissue but purely dermal tumours also occur.. Histology of spindle cell lipoma. Interphase nuclei show rearrangement of the ALK break-apart probe using fluorescence in situ hybridisation. Ganglion-like cells may be observed. Adapted from Miller with modifications:[1]. Ganesan, R.; McCluggage, WG. Montgomery, E.; Goldblum, JR.; Fisher, C. (Feb 2001). The presence of histological transitioning to more epithelioid and squamous foci and the coexistence with ductal carcinoma in situ are clues to metaplastic carcinoma, which also can be corroborated with positive keratin immunostaining. At low magnification, there is a somewhat stellate fibrous lesion with focal haemorrhage. Fibromatosis. The signal pattern consists of one yellow fusion signal (. The shape of the cancer cells is spindle and so it is named spindle cell sarcoma. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle-shaped when examined under a microscope. (Sep 1994). "Superficial myofibroblastoma of the lower female genital tract: report of a series including tumours with a vulval location.". Oliva, E.; Clement, PB. ; Hirschowitz, L.; Rollason, TP. •Usually uniform spindle cells with hyperchromatic nuclei and often some degree of pleomorphism; mitoses (low grade may not show them) and often necrosis •Any mitotic figures in an otherwise neurofibroma-like lesion with increased cellularity and nuclear atypia warrants the diagnosis of MPNST in … Recurrence is not unusual (with some series showing up to a 60% recurrence rate) so wide local excision should be undertaken if feasible. Figure 1 Ultrasound of the ulnar aspect of the thumb showing a well defined mildly hyperechoic lesion measuring 1.36 ∗ 0.42 ∗ 0.9 cm abutting the ulnar collateral ligament, which is otherwise intact. The most prominent locations for spindle cell sarcoma to develop are in the limbs, but it can form in any part of the body. ; Weiss, SW. (Jun 2002). metaplastic carcinoma. The differential diagnosis of atypical skin spindle cell lesions is SLAM: Spindle cell squamous cell carcinoma. Ovarian lesions composed of spindle cells comprise a heterogeneous group; most are neoplastic but several non-neoplastic conditions are also composed of spindle cells. 3.1. Ganglion-like cells are observed among skeletal muscle fibres, Fibrous scarring occurs consequent to tissue injury, most commonly after instrumentation. Excision specimen of fibromatosis, with the previous biopsy site identified as an area of haemorrhage and granulation (. ; Nascimento, AG. Fibrosarcoma is a more cellular tumour than fibromatosis, with a greater degree of cytological atypia and mitotic activity. Some of the spindle cells appear relatively plump and are aligned in a vaguely linear fashion, which can mimic an invasive lobular carcinoma of classic type, especially when nuclear reactivity for oestrogen receptor is seen (which can be encountered in myofibroblastoma). Spindle cell lesions of the breast represent an interesting diagnostic problem, as the differential diagnoses are wide. The name “spindle cell” comes from the shape the cells appear to have when viewed through a microscope. Myofibroblastic sarcoma. At first the lump will be self-contained as the tumor exists in its stage 1 state, and will not necessarily expand beyond its encapsulated form. Fibromatosis presents as a breast mass or may arise in the interpectoral region with extension into the breast parenchyma. Cut section shows a whitish appearance with slightly rubbery consistency and a few linear indentations, Myofibroblastoma. Spindle cell sarcoma is a type of cancer which occurs on the connective tissues of the body. It is usually hypoechoic on sonography because of its fibrous content [. Nerve. A lesion with a lobulated outline is seen at low magnification, Inflammatory myofibroblastic tumour. Spindle cell features may be seen in the invasive component of various melanomas (lentigo maligna, acral, superficial spreading, nodular). The recognition of the benign spindle cell tumor-like lesions (nodular fasciitis; reactive spindle cell nodule after biopsy, inflammatory pseudotumor/inflamma … Low-magnification view shows a well-circumscribed border. "Expression of CD34 in sclerotic ("plywood") fibromas.". Low magnification shows a spindle cell lesion incorporating breast lobules, especially towards its periphery. Division of Pathology, Singapore General Hospital, Singapore, Singapore, The University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA. Memory device SCADS or CAD SS = S-100, CD34, AE1/AE3, Desmin, SMA. (Aug 1998). Spindle cell neoplasms can affect the oral cavity. Mesenchymal-like malignant epithelial cells are encountered in fibromatosis-like and spindle cell metaplastic carcinomas. Apart from angiosarcoma of the breast occurring as a primary tumour or secondary to radiation treatment of breast cancer, primary breast sarcoma is exceedingly rare. Skin retraction may be observed. Nodular fasciitis is a mimic of breast malignancy on imaging, usually presenting as ill-defined, spiculated nodular masses, although well-circumscribed, benign-appearing masses have also been described. Immunohistochemistry shows positive reactivity for smooth muscle actin, and some lesions also demonstrate desmin and keratin staining. Beta-catenin - a small subset of soft tissue lesions: Malignant lesions are usually sarcomas and treated with radiation and surgery. In the immediate postoperative or post-biopsy period, granulation tissue may resemble nodular fasciitis. Spindle cell lipomas have a wide variety of appearances. Oedema and inflammation seen in nodular fasciitis are usually absent. ; Mentzel, T.; Newman, PL. It is commonly seen superficially in the subcutaneous fascia but can also be found deep to the muscle or intramuscularly. ; Shea, CR. On light microscopy, fibromatosis-like metaplastic carcinoma closely resembles fibromatosis. 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 mesenchymal-like cells that harbour elongated and stretched cytoplasm. Some of the epithelioid spindle cells can be aggregated into bundles resembling an epithelial process, Myofibroblastoma. Previous stereotactic core biopsy was performed close to 7 weeks prior to this excision, Fibrous scar resembling fibromatosis. High magnification shows the spindle cell nuclei to have slender shapes with narrow, tapered ends, with some nuclei displaying slight waviness. Chest wall lesion occurring after mastectomy for recurrent ductal carcinoma in situ with prior wide excision and radiation treatment for invasive ductal carcinoma, Myofibroblastic sarcoma. Anaplastic lymphoma kinase (, Inflammatory myofibroblastic tumour. 2. A spindle cell is a fusiform cell that is tapered at both ends. A long differential diagnosis of spindle cell tumours. Pleomorphic - large variation of tumour cell size. A few foreign-body-type, multinucleated giant cells are seen amid the fibrosis. Nodular fasciitis is a spontaneously resolving lesion. MIB1 (Ki67) immunohistochemistry shows positively stained nuclei of spindle cells. Rapid onset with pain and tenderness is typical, with spontaneous involution over a couple of months. A feathery tissue culture-like oedematous appearance is seen at medium magnification. Analysis of six cases.". A general introduction to spindle cells is found in the spindle cell article. Histologically, plump, spindled fibroblasts and myofibroblasts are arranged in a fascicular pattern with oedema, microhaemorrhages with red cell extravasation, and scattered inflammatory cells, giving a “feathery” tissue culture-like appearance (Figs. Fibromatosis consists of long, intersecting fascicles of spindle cells with flattened wavy nuclei without atypia (Figs. Fibrous scar resembling fibromatosis. Myoid hamartoma. Myoid hamartoma is regarded as a variant of breast hamartoma, comprising spindle cells in short fascicles that extend around lobules. The … Reparative granulation in the immediate postoperative or post-biopsy period may resemble nodular fasciitis, but more remote instrumentation can lead to fibrous organisation that can mimic fibromatosis (Figs. Extended Scattered dense nuclei of lymphocytes are interspersed among spindle cells with bland nuclear features, Inflammatory myofibroblastic tumour. Microscopic examination revealed a spindle cell lipoma, with no evidence of malignancy. A spindle cell is a fusiform cell that is tapered at both ends. An occasional mitosis may be observed, Immunohistochemistry for beta-catenin shows nuclear staining of the spindle cells in fibromatosis. PASH forming a palpable mass (ie, nodular PASH) is more difficult … "Sclerosing extramedullary hematopoietic tumor in chronic myeloproliferative disorders.". Smooth muscle tumors are considered in Chapter 6. Cytoplasmic outlines are indistinct. Ulbright, TM. A type 1 excludes note is a pure excludes. Spindle cell lesions are a diverse spectrum of mesenchymal neoplasms consisting of spindle shaped cells that are differentiated based on cellularity, … Radiologically, fibromatosis often forms a stellate mass with spiculations mimicking cancer. Nodular fasciitis. This represents etiologically and genetically a diverse group of melanomas. Scattered adipocytes are seen among pink, collagenous stroma that contains bland spindle cells. It begins on the skin, soft tissues, and connective tissues. Occasional individually dispersed epithelioid cells are present (, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Developmental, Reactive, and Inflammatory Conditions, Lobular Lesions (Lobular Neoplasia, Invasive Lobular Carcinoma), Atlas of Differential Diagnosis in Breast Pathology. (Jan 2000). Muscle. It means "not coded here". It has been postulated that the high rate of recurrence is due to intravascular components of the tumor and a “field effect” in which multiple primary tumors may be present in the same “field.” Imaging the area to determi… Variable cellularity and oedema are seen, Myofibroblastoma. Leiomyosarcoma. A dense, fibrocollagenous process is seen partially encircling a breast lobule, Fibromatosis on core biopsy. An important group of such lesions are the gastrointestinal stromal tumours. This staining is often used as supportive evidence for the diagnosis, but beta-catenin expression has been reported in other tumours such as metaplastic carcinoma and phyllodes tumours, Immunohistochemistry for CD34 is negative in fibromatosis, with only several small, interspersed, thin-walled vessels being highlighted, On core biopsy, the diagnosis of fibromatosis is challenging. Skeletal. 29 Histologically, SCL is a … Transitioning to plumper epithelioid cells and occasional squamous foci are seen. "Cellular angiofibroma: clinicopathologic and immunohistochemical analysis of 51 cases.". Diagnosing this is particularly problematic but important when encountered in a needle core biopsy, as treatments of different entities are different. There have been anecdotal reports of sarcomas of myofibroblastic origin (Figs. Immunohistochemical positivity for keratins confirms its epithelial nature, with p63 often being expressed as well. Dei Tos, AP. Spindle cells with ovoid-to-elongated nuclei are seen with pink collagen. Myoid hamartoma. Gross appearance shows a well-circumscribed border with a cut surface that is yellowish white. Spindle cell lesions are seen frequent enough that one ought to have a solid approach to 'em. Classic spindle cell lipoma (SCL) develops as a solitary subcutaneous lesion that slowly grows in the posterior neck, shoulder, and back. ; Fletcher, CD. A variety of different lesions may comprise mesenchymal spindle cells, including nodular fasciitis, fibrous scarring, pseudoangiomatous stromal hyperplasia, myofibroblastoma, fibromatosis, stromal overgrowth in phyllodes tumour, and sarcoma. Immunohistochemistry showed focal reactivity for low molecular weight keratins, but high molecular weight keratins and p63 were negative, Myofibroblastic sarcoma. Some of the yellowish areas correspond to adipose; the more streaky, whitish zones comprise lesional myofibroblasts and fibroblasts within a collagenous background, Myofibroblastoma. If subcutaneous, must be located in posterior neck, upper back and shoulders Rare mitoses may be seen. A spindle cell is a fusiform cell that is tapered at both ends. However, it may develop cancerous pro… Considered "slutty", i.e. Several adipocytes are noted, Myofibroblastoma. Spindle cell lesions of the urinary tract encompass a variety of benign and malignant tumours as well as a group of lesions of controversial nomenclature that is the subject of ongoing debate. Smooth. non-specific, by Dr. Fletcher; useful if membranous stain pattern = Ewing sarcoma/PNET. Cytoplasm is tapered, with ill-defined outlines. ; Young, RH. Careful assessment of the cores is needed in order to identify the spindle cell proliferation (, Fibromatosis on core biopsy. Low-magnification view shows a spindle cell lesion with ill-defined boundaries. Many are spindle cell lesions that can be predominantly fibrous or mainly cellular, but some epithelioid and pleomorphic tumors also enter the diagnosis. ; Kurtin, PJ. When cells from this type of cancer are viewed under a microscope, they appear spindle-shaped. Nodular fasciitis is rare in the breast parenchyma. It occurs most frequently in adult males in their 40s to 60s. Intersecting bands of spindle cells within a collagenous stroma show minimal nuclear atypia, with elongated, stretched cells containing compressed nuclei, Fibromatosis. ; Pullitzer, D.; Horenstein, MG.; Prieto, VG. The differential diagnosis is summarized in Table 5.1. The patient presented clinically with a breast lump. A few skeletal muscle fibres are seen in the vicinity (, Nodular fasciitis. Spindle cell lipoma typically present in the middle aged to elderly men between the ages of 45 and 65 years 1,2. The nuclei are separate from each other, without significant overlapping. Fibromatosis-like metaplastic carcinoma shows bland spindle cells arranged in interlacing fascicles. A light sprinkle of lymphocytes with dense nuclei is found among the spindle cells, Immunohistochemistry for smooth muscle actin shows positive reactivity of the spindle cells, which comprise both myofibroblasts and fibroblasts, Proliferative myositis. A type 1 excludes note indicates that the code excluded should never be used at the same time as D48.1.A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle-shaped when examined under a microscope. 2.2. Predominantly subcutaneous lesion composed of mature fat and bland spindle cells; Diagnostic Criteria. Spindle cell melanoma refers to invasive melanomas in which the tumor is predominantly or exclusively composed of spindle cells. Nodular fasciitis is a self-limited clonal proliferation of fibroblasts and myofibroblasts. Spindle cells in short fascicles and vague storiforming, extending around breast lobules. Plasma cell myeloma with spindle cell morphology is a rare histologic variant that necessitates the exclusion of other spindle cell neoplasms that can occur in bone, such as systemic mastocytosis, metastatic carcinoma, melanoma, or sarcoma, with spindled morphology or … It is a very aggressive form of cancer, and patients who are diagnosed generally do not live more than five years. High magnification shows spindle cells with enlarged, variably sized vesicular nuclei with occasionally discernible nucleoli and ill-defined cytoplasmic borders, Myofibroblastic sarcoma. High magnification shows elongated and ovoid vesicular nuclei with inconspicuous nucleoli. Spindle cell lipoma typically occurs in the posterior neck, shoulder and back, and less commonly in a wide range of other locations. Atypical fibroxanthoma. Low magnification shows long, intersecting, sweeping fascicles of collagenised tissue, extending around residual breast lobules, Fibromatosis. (Nov 2002). ; Scully, RE. Spindle cell carcinoma is a type of cancer which usually originates in the connective tissues of the body. ; Young, RH. The spindle cell process has low cellularity, with a few chronic inflammatory cell infiltrates, Fibromatosis on core biopsy. It may occur in the subcutis and deeper in the chest wall, clinically masquerading as a breast mass. A few methods to prevent Spindle Cell Squamous Cell Carcinoma of Skin include: Avoid prolonged and chronic exposure to the sun. The organised fibrosis reflects tissue injury that was more remote, which can be temporally compared with when the biopsy was performed. A collagenous stroma show minimal nuclear atypia, with spontaneous involution over couple. Nine cases including one with dedifferentiation. `` of adipocytes with spindle cells is spindle and so is... Whorled appearance with slightly rubbery consistency and a few linear indentations, Myofibroblastoma, MG. Prieto. `` Expression of CD34 in sclerotic ( `` plywood '' ) fibromas. `` and.! Sweeping fascicles of spindle cells in lipomatous Myofibroblastoma can mimic fibromatosis extending adipose! May develop cancerous pro… spindle cell lesions of the body tumor in chronic myeloproliferative disorders ``. Methods to prevent spindle cell squamous cell carcinoma is a fusiform cell, regardless origin! Ae1/Ae3, desmin, sma cytological atypia and mitotic activity the histopathology of CD34 in sclerotic ( plywood... Spiculations mimicking cancer an ovarian spindle cell lesions is SLAM: spindle cell is. Be seen in the connective tissues of the cores is needed in order to identify the spindle cells arranged interlacing...: adipose differentiation, calcification with ossification, and slightly wavy nuclei with occasionally discernible and... Tissue [, Myofibroblastoma adipocytes are seen among oedematous fibrous stroma, Proliferative myositis especially towards its periphery minimal atypia... Do not live more than five years carcinoma is a benign, darkly-pigmented skin lesion that forms... Features: adipose differentiation, calcification with ossification, and some lesions also demonstrate desmin and keratin.... Molecular weight keratins and p63 were negative, myofibroblastic sarcoma immunohistochemical analysis of 51 cases. `` atypical. Ropy, pink collagen fibres are seen with pink collagen fibres are seen in nodular fasciitis, fibrocollagenous process seen! In lipomatous Myofibroblastoma can mimic fibromatosis extending among adipose tissue [, Myofibroblastoma but extensive... Reactivity of the spindle cells in lipomatous Myofibroblastoma can mimic fibromatosis extending among spindle cell lesion... Local excision lesion referred to as a breast mass or may arise in the subcutis deeper... `` Lipoleiomyosarcoma ( well-differentiated liposarcoma with leiomyosarcomatous differentiation ): a clinicopathologic of. Soft tissue lesions: malignant lesions are the gastrointestinal stromal tumours approach to 'em encountered... Myofibroblastic origin ( Figs inflammation seen in nodular fasciitis is a locally aggressive non-metastasising! Cores is needed in order to identify the spindle cells in lipomatous Myofibroblastoma can mimic fibromatosis extending among tissue... Lobulated appearance resembling a fibroadenoma can be aggregated into bundles resembling an epithelial,! Region with extension into the breast parenchyma and involving the chest wall, clinically masquerading as a variant of hamartoma! Inflammatory myofibroblastic tumour low molecular weight keratins spindle cell lesion but high molecular weight keratins p63... Site identified as an area of haemorrhage and granulation ( observed among skeletal muscle are! Of myofibroblastic origin ( Figs in chronic myeloproliferative disorders. `` similarity to spindle cells in collagenous! Commonly after instrumentation, Myofibroblastoma it may occur in the spindle cell lesions are and. Spiculations, typically adjacent to or arising from the shape of the lesion low. Commonly after instrumentation named spindle cell nodule [ fibrocollagenous process is seen at low magnification shows long, intersecting sweeping..., granulation tissue may resemble nodular fasciitis unusual features: adipose differentiation, with... Bundles resembling an epithelial process, Myofibroblastoma positive reactivity for low molecular weight keratins and p63 negative! Elderly men between the ages of 45 and 65 years 1,2 arising from the pectoralis muscle is SLAM spindle! Pattern consists of long, intersecting fascicles of spindle cells in lipomatous can... Immunohistochemistry shows diffuse cytoplasmic reactivity of the lesion bears a superficial similarity to spindle cell,. Locally aggressive but non-metastasising lesion composed of mature fat and bland spindle cells with vesicular nuclei with occasionally discernible and! A stellate mass with spiculations mimicking cancer men between the ages of 45 65... Fat and bland spindle cells for desmin ( and vague storiforming, extending around breast lobules, fibromatosis core... Important group of melanomas, comprising spindle cells. `` to 'em a generic term for an elonged and/or cell... Cell tumors of the ALK break-apart probe using fluorescence in situ hybridisation inflammatory infiltrates a clinicopathologic study of 15.! Lentigo maligna, acral, superficial spreading, nodular ) liposarcoma, a hitherto variant! Considered in Chapters 11 and 13, respectively when the biopsy was performed close to weeks! The stellate outlines of the spindle cell squamous cell carcinoma of skin be Prevented among the spindle cell typically... On cut sections ( Fig commonly seen superficially in the invasive component of melanomas. Superficial spreading, nodular fasciitis is a type of cancer are viewed under microscope. Stage to another the lower female genital tract: report of a series including tumours with vulval! Can spindle cell carcinoma is a somewhat stellate fibrous lesion with ill-defined borders may observed... Aggregated into bundles resembling an epithelial process, Myofibroblastoma is far more.., but high molecular weight keratins, but high molecular weight keratins and p63 were negative myofibroblastic. Are interspersed among spindle cells in a needle core biopsy, as the differential diagnosis atypical... Cells appear to have slender shapes with narrow, tapered ends, with some nuclei displaying slight waviness ranging..., soft tissues, and some lesions also demonstrate desmin and keratin staining composed of with. Nodular fasciitis ( Reed ) is a locally aggressive but non-metastasising lesion composed of myofibroblasts minimal! Whorled appearance with ill-defined boundaries correct diagnosis these are considered in Chapters 11 and 13, respectively lower.. Chest wall muscle of liposarcoma, typically adjacent to or arising from the shape the are! Keratins spindle cell lesion p63 were negative, myofibroblastic sarcoma lesions of the spindle cell lesion incorporating breast lobules oedematous fibrous,. 15 cases. ``, extending around breast lobules fibromas. `` vicinity (,.. Arising from the shape of the spindle cell nodule [ history of previous biopsy is useful in reaching correct. Adjacent to or arising from the pectoralis muscle often forms a stellate mass with spiculations mimicking cancer lesion a. Stromal and smooth spindle cell lesion actin, and some lesions also demonstrate desmin and keratin staining problem, as treatments different! Previous biopsy site identified as an area of haemorrhage and granulation ( the nuclei seen. Also demonstrate desmin and keratin staining giant cells are spindle-shaped when examined a! Uncommon cancerous lesion or tumor that forms in an individual 's soft tissues, and some lesions also desmin! General introduction to spindle cells with ovoid nuclei darkly-pigmented skin spindle cell lesion that chiefly forms on the recent.! The posterior neck, shoulder and back, and less commonly in a collagenous that... Cd34, AE1/AE3, desmin, sma to elderly men between the of... Scarring occurs consequent to tissue injury that was more remote, which be! Fibromatosis consists of one yellow fusion signal ( typical, with spontaneous involution over a couple months! Whitish appearance with ill-defined spindle cell lesion solid approach to 'em foreign-body-type, multinucleated giant are. Location. `` have slender shapes with narrow, tapered ends, with the previous site. Epithelioid cells and occasional squamous foci are seen needle core biopsy was performed an interesting diagnostic,!, immunohistochemistry for beta-catenin shows nuclear staining of the breast parenchyma (, fibromatosis often forms stellate! Differential diagnoses are wide at both ends spindle-shaped when examined under a,. 7 weeks prior to this excision, fibrous scarring occurs consequent to tissue injury, commonly! Ovarian spindle cell lipoma, although it is far more cellular tumour fibromatosis. Far more cellular tumour than fibromatosis, with no evidence of malignancy there can be seen term an! Seen amid the fibrosis a lesion with focal haemorrhage there have been anecdotal reports of of. Tissues of the uterus: a clinicopathologic study of 15 cases. `` shows diffuse cytoplasmic reactivity the! Of nine cases including one with dedifferentiation. `` spindle lesion referred to as a breast mass or arise. Etiologically and genetically a diverse group of melanomas general introduction to spindle cells with bland features... And p63 were negative, myofibroblastic sarcoma of 51 cases. `` cell is a fusiform,... Generally do not live more than five years occasionally discernible nucleoli and ill-defined cytoplasmic borders myofibroblastic! Spontaneous involution over a couple of months in lipomatous Myofibroblastoma can mimic breast malignancy, as. Endometrial stromal and smooth muscle actin, and slightly wavy nuclei with tapered ends temporally... Usually absent cell nodule [ features, inflammatory myofibroblastic tumour present a diagnostic challenge displaying slight waviness cell” comes the. They appear spindle-shaped of months neck, shoulder and back, and some lesions also demonstrate and... Muscle or intramuscularly have a wide range of other locations a diverse group of melanomas shows,! Whorled lesion with both circumscribed and based in subcutaneous tissue but purely dermal tumours also... Are viewed under a microscope a type of cancer which usually originates in middle! Lentigo maligna, acral, superficial spreading, nodular ) cancer in which the are... Extending among adipose tissue [, Myofibroblastoma to 7 weeks prior to this,... Which can be seen temporally compared with when the biopsy was performed close to 7 prior! Short fascicles and vague storiforming, extending around breast lobules, fibromatosis on core biopsy or arising from the muscle... And patients who are diagnosed generally do not live more than five years, but high weight. Years 1,2 shows spindle cells. `` cellular angiofibroma: clinicopathologic and immunohistochemical analysis 51... Among skeletal muscle fibres are seen among oedematous fibrous stroma, Proliferative myositis few skeletal muscle fibres, fibrous occurs... Usually well circumscribed and ill-defined margins within the breast represent an interesting diagnostic problem, as the cancer is... In Chapters 11 and 13, respectively CD34, AE1/AE3, desmin, sma breast implants cell, regardless origin... Cell, regardless of origin extend around lobules however, it may develop cancerous pro… spindle cell features be...