Difference between revisions of "Spindle cell lesions"
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'''Spindle cell lesions''' are seen frequent enough that one ought to have a solid approach to 'em. | '''[[Spindle cell]] lesions''' are seen frequent enough that one ought to have a solid approach to 'em. | ||
==General DDx== | ==General DDx== | ||
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*[[Soft tissue lesions]]. | *[[Soft tissue lesions]]. | ||
*[[Immunohistochemistry]]. | *[[Immunohistochemistry]]. | ||
*[[Spindle cell]]. | |||
==References== | ==References== | ||
Revision as of 07:41, 3 February 2011
Spindle cell lesions are seen frequent enough that one ought to have a solid approach to 'em.
General DDx
Spindle cells should make think:
- Nerve.
- Muscle.
- Smooth.
- Skeletal.
- Other.
Malignant fibrous histiocytoma
Work-up (MSH):
- CD34 - GIST, angiosarcoma, solitary fibrous tumour/hemangiopericytoma, Kaposi sarcoma.
- S100 - neural marker, sensitive for malignant melanoma, Langerhans cells, clear cell sarcoma.
- Desmin - smooth muscle.
- MIB1 - proliferation.
- CD99 - immature T cells (thymus), small round cell tumours, synovial sarcoma, merkel cell carcinoma, osteosarcoma.[1]
- Considered "slutty", i.e. non-specific, by Dr. Fletcher; useful if membranous stain pattern = Ewing sarcoma/PNET.
- BCL2 - synovial sarcoma, small cell lymphomas, spindle cell lipoma.[2][3]
- PGP 9.5.
- SMMS - smooth muscle.
- Caldesmon - muscle.
- PDGFR - GIST
- DOG-1 - GIST (membranous, cytoplasmic),[4] normal pancreas (islets),[4] associated with BRCA1.
Others:
- Beta-catenin - a small subset of soft tissue lesions:
- Desmoidtype fibromatosis (~70%), solitary fibrous tumour & endometrial stromal sarcoma (~40%), synovial sarcoma (~30%).[5]
See also
References
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 108. ISBN 978-0470519035.
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 107. ISBN 978-0470519035.
- ↑ URL: http://ajp.amjpathol.org/cgi/content/full/160/3/759. Accessed on: 3 August 2010.
- ↑ 4.0 4.1 Ardeleanu C, Arsene D, Hinescu M, et al. (October 2009). "Pancreatic expression of DOG1: a novel gastrointestinal stromal tumor (GIST) biomarker". Appl. Immunohistochem. Mol. Morphol. 17 (5): 413–8. doi:10.1097/PAI.0b013e31819e4dc5. PMID 19417627.
- ↑ Ng TL, Gown AM, Barry TS, et al. (January 2005). "Nuclear beta-catenin in mesenchymal tumors". Mod. Pathol. 18 (1): 68–74. doi:10.1038/modpathol.3800272. PMID 15375433.