A spindle cell is a fusiform cell that is tapered at both ends. Low-magnification view shows a spindle cell lesion with ill-defined boundaries. Myoid hamartoma. Atypical fibroxanthoma. 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. There have been anecdotal reports of sarcomas of myofibroblastic origin (Figs. Adapted from Miller with modifications:[1]. Beta-catenin - a small subset of soft tissue lesions: Malignant lesions are usually sarcomas and treated with radiation and surgery. Fibromatosis of breast. Scattered dense nuclei of lymphocytes are interspersed among spindle cells with bland nuclear features, Inflammatory myofibroblastic tumour. "Superficial myofibroblastoma of the lower female genital tract: report of a series including tumours with a vulval location.". MIB1 (Ki67) immunohistochemistry shows positively stained nuclei of spindle cells. 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 … Carcinoma, e.g. Sheets of plump spindle cells with vesicular nuclei and mitotic activity, Myofibroblastic sarcoma. "Myofibrosarcoma: a clinicopathologic study.". The patient presented clinically with a breast lump. ; Fletcher, CD. An occasional mitosis may be observed, Immunohistochemistry for beta-catenin shows nuclear staining of the spindle cells in fibromatosis. Spindle cells should make think: 1. 29 Histologically, SCL is a … Immunohistochemistry shows positive reactivity of the spindle cells for desmin (. Nerve. It is commonly seen superficially in the subcutaneous fascia but can also be found deep to the muscle or intramuscularly. Division of Pathology, Singapore General Hospital, Singapore, Singapore, The University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA. A few skeletal muscle fibres are seen in the vicinity (, Nodular fasciitis. Spindle cell sarcoma is an uncommon cancerous lesion or tumor that forms in an individual's soft tissues or bone. (Feb 2005). 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. Spindle cells in short fascicles and vague storiforming, extending around breast lobules. 3.1. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle-shaped when examined under a microscope. An exuberant tissue response can lead to a nodular spindle lesion referred to as a spindle cell nodule [. Spindle cell carcinoma is a type of cancer which usually originates in the connective tissues of the body. But more extensive lesions may require wide local excision. ; Srigley, JR.; Hatzianastassiou, DK. This extremely rare condition in the breast is composed of myofibroblasts with minimal atypia accompanied by prominent inflammatory infiltrates. There is usually no tissue culture-like appearance. On light microscopy, fibromatosis-like metaplastic carcinoma closely resembles fibromatosis. The name “spindle cell” comes from the shape the cells appear to have when viewed through a microscope. Spindle cell lesions of the breast represent an interesting diagnostic problem, as the differential diagnoses are wide. Rapid onset with pain and tenderness is typical, with spontaneous involution over a couple of months. Myoid hamartoma. It may occur in the subcutis and deeper in the chest wall, clinically masquerading as a breast mass. 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. 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. If subcutaneous, must be located in posterior neck, upper back and shoulders The spindle cells show elongated, wavy nuclei. Spindle cell neoplasms can affect the oral cavity. ; Young, RH. Oliva, E.; Clement, PB. ; McNutt, NS. Ganglion-like cells may be observed. Spindle cell features may be seen in the invasive component of various melanomas (lentigo maligna, acral, superficial spreading, nodular). Spindle cell melanoma refers to invasive melanomas in which the tumor is predominantly or exclusively composed of spindle cells. ; Nascimento, AG. "Leydig cell tumors of the testis with unusual features: adipose differentiation, calcification with ossification, and spindle-shaped tumor cells.". Hanft, VN. It begins on the skin, soft tissues, and connective tissues. Montgomery, E.; Goldblum, JR.; Fisher, C. (Feb 2001). Fibromatosis is a locally aggressive but non-metastasising lesion composed of fibroblasts and myofibroblasts. Dei Tos, AP. Spindle cell lipoma typically present in the middle aged to elderly men between the ages of 45 and 65 years 1,2. 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. "Mixed endometrial stromal and smooth muscle tumors of the uterus: a clinicopathologic study of 15 cases.". "Cellular angiofibroma: clinicopathologic and immunohistochemical analysis of 51 cases.". Definition. Ovarian lesions composed of spindle cells comprise a heterogeneous group; most are neoplastic but several non-neoplastic conditions are also composed of spindle cells. Diagnosing this is particularly problematic but important when encountered in a needle core biopsy, as treatments of different entities are different. Myofibroblastic sarcoma. The tumor usually measures 3 to 5 cm. 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. Low-magnification view shows a well-circumscribed border. They are usually well circumscribed and based in subcutaneous tissue but purely dermal tumours also occur.. Histology of spindle cell lipoma. However, it may develop cancerous pro… A lesion with a lobulated outline is seen at low magnification, Inflammatory myofibroblastic tumour. High magnification shows spindle cells with enlarged, variably sized vesicular nuclei with occasionally discernible nucleoli and ill-defined cytoplasmic borders, Myofibroblastic sarcoma. Several adipocytes are noted, Myofibroblastoma. Fibrous scar resembling fibromatosis. Smooth muscle tumors are considered in Chapter 6. Ropy, pink collagen fibres are seen among the spindle cells with ovoid nuclei. This review discusses the main differential diagnoses of an ovarian spindle cell lesion, especially concentrating on the recent literature. Excision biopsy shows the stellate outlines of the lesion at low magnification. Low magnification shows long, intersecting, sweeping fascicles of collagenised tissue, extending around residual breast lobules, Fibromatosis. In the histologic assessment …. It is a very aggressive form of cancer, and patients who are diagnosed generally do not live more than five years. (Jan 2000). Pigmented Spindle Cell Nevus (Reed) is a benign, darkly-pigmented skin lesion that chiefly forms on the upper and lower limbs. High magnification shows slender, elongated, and slightly wavy nuclei with tapered ends. A dense, fibrocollagenous process is seen partially encircling a breast lobule, Fibromatosis on core biopsy. In fibromatosis, there are long, intersecting fascicles of spindle cells in a collagenous background. 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. (Aug 1998). Skin retraction may be observed. 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