![]() Spindle cell sarcomas (malignant fibrous histiocytoma, hemangiopericytoma, fibrosarcoma, leiomyosarcoma, synovial sarcoma) are the most common primary pulmonary sarcomas. Marom, in Tumors and Tumor-Like Conditions of the Lung and Pleura, 2010 Mesenchymal Malignant Tumors of the Lung It is important that monophasic synovial sarcoma and the fibrosarcomatous (higher grade) variant of dermatofibrosarcoma protuberans should not be lost in this category, as these two diagnoses may have specific chemotherapeutic implications.Įdith M. Some likely represent MPNST, less than 40% of which express nerve sheath antigens, since electron microscopy, which might have been informative, is only infrequently used (or even available) for tumor diagnosis nowadays. Some of these tumors likely represent true fibrosarcomas or myofibrosarcomas, but diagnostic criteria are not adequately or fully defined in that regard as yet. Histologic grade is variable, as also is the extent of collagenous matrix. Most have a fascicular growth pattern and either amphophilic or palely eosinophilic cytoplasm with tapering nuclei. The majority of unclassified spindle cell sarcomas, in this author's experience, arise in somatic soft tissue across a very broad age range. Fletcher MD, FRCPath, in Diagnostic Histopathology of Tumors, 2021 Unclassified Spindle Cell Sarcomas In all cases, a rapid and accurate diagnosis is important for treatment and prognosis.Christopher D.M. They metastasise rarely (apart from haemangiosarcomas). Wide surgical excision is the treatment of choice. Sarcomas are often highly infiltrative and locally aggressive, with a high likelihood of recurrence. Spindle cell proliferation occurs as a fibroplastic response in granulomatous inflammation, and this may be impossible to differentiate from benign or malignant neoplasms.Ī biopsy and histopathology are usually necessary to confirm the diagnosis.īenign forms are usually well circumscribed and can be surgically removed with an excellent prognosis. Large, plump spindle cells large nuclei and prominent nucleoli prominent nuclear variability multinucleated giant cells pink extracellular stroma Often, a diagnosis of spindle cell tumour is as specific a diagnosis as can be made.Ĭommon cytological findings for benign spindle cell tumours include: small spindle-shaped cells, small nuclei, minimal anisocytosis.Ĭyological findings for sarcomas include: It may be possible to determine the tissue of origin if there is evidence of collagen, cartilage, bone, fat or myxomatous material formation by the tumour cells. Nuclei are often fusiform as well and cytoplasmic tails may fade into the background. On cytological examination: cells are individual rather than adherent, fusiform, and with indistinct cell borders. Generally spindle cell tumours do not exfoliate well, although exceptions exist. Other tumours Haemangiopericytoma and Schwannoma Diagnosis Tumours of the lymphatics Lymphangioma and lymphangiosarcoma Tumours of the blood vessel endothelium Haemangioma and Haemangiosarcoma Tumours of muscle Leiomyoma and leiomyosarcoma It can be difficult to differentiate between the different forms of spindle cell tumours, and also to distinguish between spindle cell neoplasia and a fibroplastic spindle cell proliferative response.Ĭonnective tissue tumours Fibroma and Fibrosarcoma Myxoma and myxosarcoma Spindle cell tumours can be benign (suffix -oma) or malignant (suffix -sarcoma), and will arise from these different cell lines. The name 'spindle cell' refers to the shape of the cell on cytology and histology. Spindle cells are of mesenchymal origin, and form the body's connective tissue, fat, muscle, bone, cartilage and blood vessels.
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