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Results for “spindle cell lesion”

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At least 19 recordsLinked to original sources

PubMed2026

Loss of Methylthioadenosine Phosphorylase (MTAP) Expression: A Potentially Useful Tool for Distinguishing Sarcomatoid Urothelial Carcinoma From Inflammatory Myofibroblastic Tumor.

Inflammatory myofibroblastic tumor (IMT) and sarcomatoid urothelial carcinoma (SarUC) can have striking histologic overlap but have significantly different prognoses and clinical management paradigms. Loss of methylthioadenosine phosphorylase (MTAP) protein expression by immunohistochemistry (IHC) serves as a useful surrogate for homozygous 9p21 deletion, a recurrent genomic alteration in urothelial carcinoma (UC). We analyzed MTAP expression by IHC in 65 SarUCs and 27 urinary tract IMTs to evaluate its utility in navigating this challenging differential diagnosis. Overall, MTAP loss was significantly more frequent in SarUC (55%) compared with IMT (4%) (P < .0001). Among 46 biphasic SarUCs with independently evaluable epithelial and mesenchymal components, divergent expression patterns were frequent. The most common pattern was retention of MTAP staining in both epithelial and mesenchymal components (19/46; 41% of cases), followed by selective retention of MTAP in the epithelial component and loss in the mesenchymal component (16/46; 35% of cases). MTAP loss was observed in both the epithelial and mesenchymal components in 11 out of 46 (24%) SarUC cases. None of the 46 biphasic SarUC cases showed selective MTAP loss in the epithelial component but retention in the mesenchymal component. MTAP IHC was also particularly valuable in assessing clonal relationships in 2 challenging biphasic cases in which the differential diagnosis included a collision between a noninvasive low-grade papillary UC and an IMT versus a subtle IMT-like SarUC arising in association with an overlying noninvasive low-grade papillary UC. Next-generation sequencing on a subset of cases (n = 11) was useful for confirming 9p deletion in cases with MTAP loss by IHC, and for demonstrating molecular hallmarks of urothelial neoplasia thereby providing additional diagnostic support for morphologically challenging SarUC cases with IMT-like morphology. Therefore, MTAP IHC can be useful in evaluating spindle cell lesions of the urinary tract, as loss is significantly more common in SarUC than in IMT, and enriched in the mesenchymal component of biphasic SarUC. However, MTAP loss can be seen in both entities, and the diagnosis of IMT-like spindle cell tumors in the urinary tract requires careful integration of morphologic, immunohistochemical, and molecular data.

Humans↗

PubMed1992

Case report 714. Postirradiation osteosarcoma after radiation of metastatic skeletal lesion.

Two cases of postirradiation osteosarcoma are presented--one in a 76-year-old woman with breast carcinoma and subsequent osteosarcoma after radiation therapy for a metastatic lesion in the right tibia, and the other in a 16-year-old girl with hepatocellular carcinoma metastatic to the left tibia and osteosarcoma after radiation therapy to that bone. Microscopically, both cases were high-grade spindle cell lesions with osteoid production. Both patients fared poorly. This is a rare complication of radiation therapy.

Adenocarcinoma↗

PubMed1976

The clinical aspects of mesothelioma.

Three hundred and twenty-seven cases of mesothelioma accepted by a panel of pathologists have been used to construct a clinical picture of the disease. The cases analysed died between 1 January 1960 and 31 December 1969 and consisted of 267 pleural, 37 peritoneal, and 23 cases which could have arisen in either site. Two hundred and sixty-eight were in men and 59 in women and the disease appeared to be the same in women as in men. The mean age at death was 59-37 (+/- SD 9-89) years but ranged from 29 to 88 years. The mode of onset was insidious in all but a few cases and the mean interval before reaching the hospital was 3-39 (+/- SD 4-64) months for pleural and 3-08 (+/- SD 3-22) for peritoneal cases. Patients usually noticed a dull non pleuritic pain first but suffered some breathlessness, lassitude and weight loss by the time they reached hospital. On examination there was little evidence of disease apart from the signs of pleural effusion or thickening or ascites. Clubbing and signs of asbestosis were rare except in the peritoneal cases who more frequently gave an occupational history of heavy exposure and showed the radiological consequences of this. At the time when these patients were investigated diagnostic procedures were unrewarding and many patients were only diagnosed in retrospect. The prognosis was somewhat better for patients shown to have mainly epithelial cell tumours, 17-89 (+/- SD 18-26) months, predominantly spindle cell lesions surviving on the average only 7-98 (+/- SD 8-55) months and mixed tumours 11-3 months. The criteria for the early clinical diagnosis are described with a view of facilitating the search for effective treatment.

Adult↗

PubMed1992

The fibroma-like variant of epithelioid sarcoma. A fibrohistiocytic/myoid cell lesion often confused with benign and malignant spindle cell tumors.

Five cases of a previously undescribed variant of epithelioid sarcoma are presented. This variant differs from the usual lesion in its absence of the typical necrobiotic nodular epithelioid pattern. It is instead composed of deceptively bland fibrohistiocytic and myoid cells arranged in a fibroma-like or dermatofibroma-like pattern with an affinity for osseous involvement. The clinical presentation, ultrastructural features, and presence of vimentin and low molecular weight keratin within the tumor cells justifies their designation as an epithelioid sarcoma variant.

Adolescent↗

PubMed1992

Spindle cell haemangioendothelioma: probably a benign vascular lesion not a low-grade angiosarcoma. A clinicopathological, ultrastructural and immunohistochemical study.

Ten cases of spindle cell haemangioendothelioma (SCH) were analysed clinicopathologically, including an immunohistochemical survey of seven cases and ultrastructural observations on one. There were seven females and three males, ranging from 16 to 76 years of age. All but one lesion developed on the extremities, predominantly on the hands and feet. Six of the ten patients presented multiple nodules or papules which gradually increased in size and number over a long duration. Among them, four patients had undergone operations twice or more, but no metastatic foci were recognized. Histologically, the lesions were composed of dilated vascular spaces and a proliferation of bland-appearing spindle cells and interspersed epithelioid endothelial cells. Ultrastructural and immunohistochemical studies demonstrated that the spindle cells were mainly made up of fibroblastic cells admixed with pericyte-like cells and macrophages. Smooth muscle cells and primitive mesenchymal cells were also present. The clinical and microscopic features suggest that SCH may be a benign vasoformative lesion of a heterochronological multicentric origin.

Adolescent↗

PubMed1977

So-called pseudosarcoma of the esophagus: nodal metastases of the spindle cell element.

A polypoid lesion of the esophagus with all the morphological features of a so-called pseudosarcoma produced nodal metastases of the spindle cell element. Ultrastructurally, these spindle cells showed only fibroblastic features. The findings in this case and a review of cases reported as pseudosarcoma of the esophagus lend little support for the contention that they differ from cases categorized as carcinosarcoma of the esophagus.

Aged↗

PubMed2026

Fibromatosis-Like Metaplastic Triple-Negative Breast Cancer: A Case Report.

Fibromatosis-like metaplastic carcinoma (FLMC) is an extremely rare subtype of metaplastic breast carcinoma that closely resembles desmoid-type fibromatosis histologically, making it one of the most diagnostically challenging breast lesions. In contrast to most triple-negative breast cancers, FLMC follows a relatively indolent clinical course, though local recurrence is well documented, and because so few cases have been reported, no established treatment guidelines exist and the role of chemotherapy remains uncertain. We present the case of a 63-year-old woman recalled from routine screening digital breast tomosynthesis for an irregular, spiculated mass in the right breast, confirmed on biopsy to be FLMC, and treated with breast-conserving surgery and adjuvant radiation therapy without chemotherapy after two medical oncologists gave opposing recommendations regarding systemic treatment. She has remained without evidence of disease at two-year follow-up. This case adds to the limited literature on FLMC, supports surgery and radiation alone as a potentially effective treatment strategy in carefully selected patients, and highlights the importance of recognizing FLMC as a biologically distinct entity that should not be managed the same way as conventional triple-negative breast cancer, though longer-term follow-up is needed given the limited data on treatment outcomes for this rare tumor.

breast conservation↗

PubMed1979

Melanoma resembling spindle and epithelioid cell nevus.

Three cases of malignant melanoma resembling spindle and epithelioid cell nevus histologically are presented. Lesions having histologic features of spindle and epithelioid cell nevus (Spitz nevus or juvenile melanoma) at or after puberty should be regarded with caution, particularly when they are heavily melanized. Such lesions are in a histologic "gray zone" and may be malignant.

Adolescent↗

PubMed1992

Spindle cell hemangioendothelioma exhibits the ultrastructural features of reactive vascular proliferation rather than of angiosarcoma.

A patient with spindle cell hemangioendotheliomas was followed from 1964 to the present time, allowing the authors the opportunity to examine the lesions in the early, mature, and old phases. Organizing thrombi of different stages associated with slit-like vascular proliferation were always observed, whereas cavernous vascular spaces predominated as the lesions became older. Each spindle cell hemangioendothelioma initially developed relatively rapidly and was sometimes painful but then persisted as a silent nodule for decades. Transmission and scanning electron microscopic studies revealed that endothelial cells tended to digitate into the slit-like proliferating channels, became attached to other cells by means of tight junctions, and thus obstructed the channels at sites where thrombi developed repeatedly. The vascular spaces, ranging in nature from slit-like to cavernous, were outlined further by a relatively sparse mantle of ramified or dendritic interstitial cells that corresponded to spindle cells. Most of the cells appeared simply to be fibroblasts, but they developed the features of pericytes when they were close to the endothelial lining of well-developed vascular lumens. Large vascular spaces and phleboliths were surrounded by smooth muscle cells. Approximately 20% of the interstitial cells were dendritic macrophages characterized by phagocytic activity, presence of many lysosomes, and Factor XIIIa expression. The long and characteristic clinical course, the histologic evidence that thrombosis and its organization was continually occurring within the lesions, and the ultrastructural finding that spindle cell hemangioendotheliomas were composed of different microvascular segments from capillaries to veins, suggest that spindle cell hemangioendotheliomas may develop from a cycle of recanalization after thrombosis that occurs repeatedly because of the unique endothelial growth that was noted. This is in contrast with the previous conception that they were low-grade angiosarcomas.

Adult↗

PubMed1977

Atypical fibroxanthoma of the skin: an ultrastructural study of two cases.

The ultrastructure of two atypical" fibroxanthomas of the skin was studied. The first lesion was a spindle cell tumor on light microscopy, which electron microscopy revealed was composed of undifferentiated mesenchymal cells. The second lesion had a highly pheomorphic appearance on both light and electron microscopy. It was formed by atypical histiocytic cells and abundant "typical" Langerhans cells. The second lesion was considered to be a proliferation either of atypical Langerhans cells or of histiocytes related to Langerhans cells. Thus, atypical fibroxanthoma of skin may not be a homogeneous entity but could be a group of mesenchymal proliferative lesion in a similar clinical setting.

Aged↗

PubMed1976

Hemangiopericytoma-like intranasal tumors. A clinicopathologic study of 23 cases.

The clinical, microscopic, and gross pathologic features of 23 cases of intranasal hemangiopericytoma-like tumors are reviewed and studied. When in the nasal cavity, these lesions often originated in a paranasal sinus and extended into the nasal cavity secondarily. They occurred most commonly in adults in the sixth and seventh decades of life; there was no significant sex predilection. Twenty-two of the 23 patients were Caucasian. These patients most commonly had symptoms of nasal obstruction and epistaxis. Clinically the lesions were generally thought to represent allergic polyps. Although appearing microscopically as non-differentiated spindle-cell neoplasms, these lesions showed little nuclear or cytoplasmic pleomorphism, minimal mitotic activity, and no necrosis or hemorrhage or other evidence of anaplasia found in malignant tumors. Follow-up data showed no evidence to suggest a malignant or biologically unpredictable lesion. Nineteen of 22 cases followed showed no recurrence regardless of the treatment; those that recurred did so locally. No metastasis or other form of aggressive behavior attributed to hemangiopericytomas in other anatomic locations was seen in this series. Another case, diagnosed as a malignant hemangiopericytoma of the nasal cavity, showed dissimilar and anaplastic histologic features. This case metastasized and is discussed, though not included in this study.

Adolescent↗

PubMed1992

Myofibroblastic pseudotumor mimicking epididymal sarcoma. A clinicopathologic study of three cases.

The clinical and pathologic features of three cases of epididymal pseudotumor are described with emphasis on its differential diagnosis and histopathogenesis. The first lesion was found histologically worrisome in the region of ductus epididymis by a torsioned testis in an 8-month-old boy, although the lesion was clinically indistinctive, and grossly not remarked. Histodiagnostic difficulties are encountered because this lesion forms numerous infiltrative spindle cells in haphazard arrangement. Ultrastructurally, the cell components of this lesion are predominantly myofibroblasts, intermediate cells between fibroblasts and myocytes. Similar epididymal lesions with the same cell components were identified in the two other infantile cases on the review of 36 consecutive orchiectomy specimens all obtained for testicular torsion. These three boys were found to present with a relatively gradual clinical course of the testicular torsion. It is suggested that myofibroblastic proliferation in the epididymal location histologically reminiscent of sarcomas occurs under ischemic circumstances.

Diagnosis, Differential↗

PubMed1976

Polypoid spindle-cell carcinoma (pleomorphic carcinoma). Report of a case occurring on tongue and review of the literature.

A case of spindle-cell carcinoma (pleomorphic carcinoma), a rare polypoid tumor of the tongue, is reported. The characteristic clinical, gross, and microscopic features of this peculiar lesion and its common sites of location are presented. Origin and pathogenesis of the sarcoma-like elements of the lesion are discussed and the literature on the subject is reviewed. Sites of apparent transition between the spindle cell elements of the tumor and the overlying epithelium were observed in light microscopic sections, and the electron micrographs of the spindle-cell portion of the lesion demonstrated the presence of tonofilaments and desmosomes in many tumor cells. These findings support the concept that this group of lesions are pleomorphic variants of squamous-cell carcinoma with predominantly spindle-cell pattern. Current evidence in the literature also suggests that metaplastic transformation of the tumor cells into mesenchymal elements may take place in some of these lesions, and that "metaplastic carcinoma" may probably be a more proper designation for them.

Aged↗

PubMed2025

The elevated expression of ORF75, a KSHV lytic gene, in Kaposi sarcoma lesions is driven by a GC-rich DNA cis element in its promoter region.

The spindle cells of Kaposi sarcoma (KS) lesions primarily express Kaposi sarcoma herpesvirus (KSHV) latent genes with minimal expression of lytic genes. However, recent transcriptome analyses of KS lesions have shown high expression of KSHV open reading frame (ORF) 75, which is considered a late lytic gene based on analyses in primary effusion lymphoma (PEL) lines. ORF75 encodes a pseudo-amidotransferase that is part of the viral tegument, acts as a suppressor of innate immunity, and is essential for viral lytic replication. We assessed a representative KS lesion by RNAscope and found that ORF75 RNA was expressed in the majority of latency-associated nuclear antigen (LANA)-expressing cells. Luciferase fusion reporter constructs of the ORF75 promoter were analyzed for factors potentially driving its expression in KS. The ORF75 promoter construct showed high basal transcriptional activity in vitro in endothelial cells, mediated by a proximal consensus specificity protein 1 (Sp1) (GGGGCGGGGC) element along with two distal CCAAT boxes. Sp proteins formed complexes with the proximal consensus Sp1 element to activate ORF75 promoter transcription. We also found evidence that a repressive factor or factors in B cells, but not endothelial or epithelial cells, interacted with more distal elements in the ORF75 promoter region to repress constitutive ORF75 expression in B cells. Alternate forms of Sp1 were found to accumulate during latency and showed substantial enrichment during viral lytic replication in PEL cells and infected endothelial cells, but their functional significance is unclear. We also found that ORF75 can in turn upregulate its own expression and that of other KSHV genes. Thus, while ORF75 acts primarily as a lytic gene in PEL cell lines, Sp proteins induce substantial constitutive ORF75 transcription in infected endothelial cells and this can account for its high expression in KS lesions.

Herpesvirus 8, Human↗

PubMed1979

Spindle cell lipoma of the orbit.

A 42-year-old woman had an orbital mass lesion removed surgically that proved histologically to be a spindle cell lipoma. To our knowledge, this is the first reported case of a spindle cell lipoma arising in the orbit. This specific type of lipoma occurs chiefly in male patients and is believed to affect the shoulder and posterior neck regions almost exclusively. Spindle cell lipomas, while having unusual features histologically, are benign and should not be mistaken for liposarcomas or other spindle cell soft-tissue tumors.

Adult↗

PubMed1979

Neurogenic sarcoma of the head and neck.

We discuss our experience in the diagnosis and management of seven cases of neurogenic sarcomas of the head and neck. These uncommon tumors, which affect all ages, arise most frequently from the brachial plexus, sympathetic chain, and the cranial nerves or their branches. An enlarging mass is the most common initially appearing symptom. Diagnosis may be difficult and rests heavily on gross evidence of a relationship between the tumor and its nerve of origin. Histologically, the lesions are composed of spindle cells with varying degrees of pleomorphism in a pattern that is frequently undistinguishable from fibrosarcomas. Ultrastructural studies may be helpful in establishing the neurogenic origin of these tumors. Neurogenic sarcoma of the head and neck has an extremely poor prognosis. Surgery remains the cornerstone of treatment, although radiotherapy is important for palliation.

Accessory Nerve↗

PubMed1977

Ischemic colitis and malignant atrophic papulosis.

A 37-year old male with a history of idiopathic nephrotic syndrome, hypertension, severe headaches and transient ischemic attacks developed ischemic colitis with stricture formation of the spelnic flexure. Eschemic changes were secondary to vascular lesions involving the middle colic artery and mulitple smaller arteries and arterioles. The vascular lesion is localized to the intimal layer with proliferation of spindle-shaped cells indentical to the gastrointestinal lesion of malignant atrophic papulosis (Degos' disease). The patient had no skin biopsy, or history of skin lesions. This case represents ischemic colitis in a patient with malignant atrophic papulosis with either absent or unrecognized skin lesions.

Adult↗

PubMed1992

Mycobacterial spindle cell pseudotumor of lymph nodes.

Two cases of spindle cell pseudotumor in the lymph nodes of patients with acquired immunodeficiency syndrome caused by mycobacterial infection are reported and the literature reviewed. The lesions mimicked neoplasms because they were composed predominantly of spindle cells arranged in a storiform pattern. Most of the spindle cells were phagocytic cells that contained large amounts of mycobacteria. It is important for the pathologist to recognize the lesion so that a prompt tissue diagnosis can be provided because specific therapy is available.

Acquired Immunodeficiency Syndrome↗