Cytoplasmic outlines are indistinct. MIB1 (Ki67) immunohistochemistry shows positively stained nuclei of spindle cells. Extended But more extensive lesions may require wide local excision. 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. 29 Histologically, SCL is a … It is a very aggressive form of cancer, and patients who are diagnosed generally do not live more than five years. metaplastic carcinoma. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle-shaped when examined under a microscope. Fibromatosis can mimic breast malignancy, presenting as an ill-defined mass with spiculations, typically adjacent to or arising from the pectoralis muscle. Montgomery, E.; Goldblum, JR.; Fisher, C. (Feb 2001). Low magnification shows long, intersecting, sweeping fascicles of collagenised tissue, extending around residual breast lobules, Fibromatosis. A lobulated appearance resembling a fibroadenoma can be seen. The differential diagnosis of atypical skin spindle cell lesions is SLAM: Spindle cell squamous cell carcinoma. 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. Other. The shape of the cancer cells is spindle and so it is named spindle cell sarcoma. A dense, fibrocollagenous process is seen partially encircling a breast lobule, Fibromatosis on core biopsy. Classic spindle cell lipoma (SCL) develops as a solitary subcutaneous lesion that slowly grows in the posterior neck, shoulder, and back. A general introduction to spindle cells is found in the spindle cell article. Anaplastic lymphoma kinase (, Inflammatory myofibroblastic tumour. 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. Fibrosarcoma is a more cellular tumour than fibromatosis, with a greater degree of cytological atypia and mitotic activity. Mesenchymal-like malignant epithelial cells are encountered in fibromatosis-like and spindle cell metaplastic carcinomas. Fibromatosis consists of long, intersecting fascicles of spindle cells with flattened wavy nuclei without atypia (Figs. ; Hirschowitz, L.; Rollason, TP. ; Weiss, SW. (Jun 2002). 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. Leiomyosarcoma. A few foreign-body-type, multinucleated giant cells are seen amid the fibrosis. 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 … Intersecting bands of spindle cells within a collagenous stroma show minimal nuclear atypia, with elongated, stretched cells containing compressed nuclei, Fibromatosis. A spindle cell is a fusiform cell that is tapered at both ends. ; Young, RH. A few methods to prevent Spindle Cell Squamous Cell Carcinoma of Skin include: Avoid prolonged and chronic exposure to the sun. Immunohistochemistry shows positive reactivity for smooth muscle actin, and some lesions also demonstrate desmin and keratin staining. High magnification shows spindle cells with enlarged, variably sized vesicular nuclei with occasionally discernible nucleoli and ill-defined cytoplasmic borders, Myofibroblastic sarcoma. Adapted from Miller with modifications:[1]. Analysis of six cases.". Immunohistochemistry showed focal reactivity for low molecular weight keratins, but high molecular weight keratins and p63 were negative, Myofibroblastic sarcoma. Myoid hamartoma. An important group of such lesions are the gastrointestinal stromal tumours. (Aug 1998). At low magnification, there is a somewhat stellate fibrous lesion with focal haemorrhage. Nodular fasciitis is a self-limited clonal proliferation of fibroblasts and myofibroblasts. Spindle cell lipomas have a wide variety of appearances. Spindle cell lesions are a diverse spectrum of mesenchymal neoplasms consisting of spindle shaped cells that are differentiated based on cellularity, … (Feb 2005). Rapid onset with pain and tenderness is typical, with spontaneous involution over a couple of months. Smooth muscle tumors are considered in Chapter 6. 2.1. Spindle cells in short fascicles and vague storiforming, extending around breast lobules. 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). 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. "Cellular angiofibroma: clinicopathologic and immunohistochemical analysis of 51 cases.". ; Nascimento, AG. 3. Memory device SCADS or CAD SS = S-100, CD34, AE1/AE3, Desmin, SMA. 2. Oedema and inflammation seen in nodular fasciitis are usually absent. A type 1 excludes note is a pure excludes. Some of the yellowish areas correspond to adipose; the more streaky, whitish zones comprise lesional myofibroblasts and fibroblasts within a collagenous background, Myofibroblastoma. Several dark nuclei of scattered lymphocytes are present, Nodular fasciitis. The organised fibrosis reflects tissue injury that was more remote, which can be temporally compared with when the biopsy was performed. Spindle cell lesions of the breast represent an interesting diagnostic problem, as the differential diagnoses are wide. ; Shea, CR. Spindle cell carcinoma is a type of cancer which usually originates in the connective tissues of the body. Iwasa, Y.; Fletcher, CD. It occurs most frequently in adult males in their 40s to 60s. Microscopic examination revealed a spindle cell lipoma, with no evidence of malignancy. Nodular fasciitis. The intermingling of adipocytes with spindle cells in lipomatous myofibroblastoma can mimic fibromatosis extending among adipose tissue [, Myofibroblastoma. Spindle cell lesions of the breast cover a wide spectrum of diseases ranging from reactive tumor-like lesions to high-grade malignant tumors. ; McNutt, NS. Myoid hamartoma. The … The spindle cells show elongated, wavy nuclei. Considered "slutty", i.e. The nuclei are separate from each other, without significant overlapping. Many are spindle cell lesions that can be predominantly fibrous or mainly cellular, but some epithelioid and pleomorphic tumors also enter the diagnosis. There have been anecdotal reports of sarcomas of myofibroblastic origin (Figs. ; Mentzel, T.; Newman, PL. "Superficial myofibroblastoma of the lower female genital tract: report of a series including tumours with a vulval location.". It starts with just a small lump and inflammation and then the symptoms slowly progress as the cancer grows from one stage to another. ; Young, RH. "Expression of CD34 in sclerotic ("plywood") fibromas.". Spindle cell sarcoma is a type of cancer which occurs on the connective tissues of the body. A spindle cell is a fusiform cell that is tapered at both ends. Nerve. Spindle cell lesions are seen frequent enough that one ought to have a solid approach to 'em. Spindle cell hemangioendothelioma. "Sclerosing extramedullary hematopoietic tumor in chronic myeloproliferative disorders.". However, it may develop cancerous pro… Spindle cells should make think: 1. 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. It begins on the skin, soft tissues, and connective tissues. Scattered adipocytes are seen among pink, collagenous stroma that contains bland spindle cells. Pleomorphic - large variation of tumour cell size. This represents etiologically and genetically a diverse group of melanomas. Division of Pathology, Singapore General Hospital, Singapore, Singapore, The University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA. 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. "Mixed endometrial stromal and smooth muscle tumors of the uterus: a clinicopathologic study of 15 cases.". 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. The tumor usually measures 3 to 5 cm. High magnification shows slender, elongated, and slightly wavy nuclei with tapered ends. (Nov 2004). The spindle cells are histologically bland and show smooth muscle differentiation, which may be verified with desmin and smooth muscle markers on immunohistochemistry (Figs. (Jan 2000). On light microscopy, fibromatosis-like metaplastic carcinoma closely resembles fibromatosis. This type of cancer can occur on nearly any of the onnective tissues of the body, including the stomach, muscles, and lungs. It is commonly seen superficially in the subcutaneous fascia but can also be found deep to the muscle or intramuscularly. Fibromatosis is a locally aggressive but non-metastasising lesion composed of fibroblasts and myofibroblasts. A spindle cell is a fusiform cell that is tapered at both ends. ; Srigley, JR.; Hatzianastassiou, DK. They are usually well circumscribed and based in subcutaneous tissue but purely dermal tumours also occur.. Histology of spindle cell lipoma. There is usually no tissue culture-like appearance. ; Pullitzer, D.; Horenstein, MG.; Prieto, VG. Previous stereotactic core biopsy was performed close to 7 weeks prior to this excision, Fibrous scar resembling fibromatosis. Variable cellularity and oedema are seen, Myofibroblastoma. 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. non-specific, by Dr. Fletcher; useful if membranous stain pattern = Ewing sarcoma/PNET. Gross specimen shows a whitish whorled lesion with both circumscribed and ill-defined margins within the breast parenchyma and involving the chest wall muscle. The signal pattern consists of one yellow fusion signal (. Dei Tos, AP. SMA immunohistochemistry shows diffuse cytoplasmic reactivity of the spindle cells. There can be an association with trauma or breast implants. Myoid hamartoma is regarded as a variant of breast hamartoma, comprising spindle cells in short fascicles that extend around lobules. "Spindle cell liposarcoma, a hitherto unrecognized variant of liposarcoma. It may occur in the subcutis and deeper in the chest wall, clinically masquerading as a breast mass. Interphase nuclei show rearrangement of the ALK break-apart probe using fluorescence in situ hybridisation. Low magnification shows a spindle cell lesion incorporating breast lobules, especially towards its periphery. Gross appearance shows a well-circumscribed border with a cut surface that is yellowish white. Diagnosing this is particularly problematic but important when encountered in a needle core biopsy, as treatments of different entities are different. Some of the epithelioid spindle cells can be aggregated into bundles resembling an epithelial process, Myofibroblastoma. Several adipocytes are noted, Myofibroblastoma. A low-grade angiosarcoma resembling a … A fibrous, whorled appearance with ill-defined borders may be observed on cut sections (Fig. A feathery tissue culture-like oedematous appearance is seen at medium magnification. Intra‐abdominal spindle cell lesions are uncommon and often present a diagnostic challenge. If subcutaneous, must be located in posterior neck, upper back and shoulders Immunohistochemical positivity for keratins confirms its epithelial nature, with p63 often being expressed as well. A long differential diagnosis of spindle cell tumours. Spindle cell features may be seen in the invasive component of various melanomas (lentigo maligna, acral, superficial spreading, nodular). (Sep 1994). 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. When cells from this type of cancer are viewed under a microscope, they appear spindle-shaped. How can Spindle Cell Squamous Cell Carcinoma of Skin be Prevented? Ulbright, TM. Skeletal. Remstein, ED. Carcinoma, e.g. Oliva, E.; Clement, PB. Atypical fibroxanthoma. Spindle cell sarcoma is an uncommon cancerous lesion or tumor that forms in an individual's soft tissues or bone. PASH forming a palpable mass (ie, nodular PASH) is more difficult … Radiologically, fibromatosis often forms a stellate mass with spiculations mimicking cancer. Muscle. Ganglion-like cells may be observed. High magnification shows elongated and ovoid vesicular nuclei with inconspicuous nucleoli. The most prominent locations for spindle cell sarcoma to develop are in the limbs, but it can form in any part of the body. The name “spindle cell” comes from the shape the cells appear to have when viewed through a microscope. Low-magnification view shows a spindle cell lesion with ill-defined boundaries. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle-shaped when examined under a microscope. 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. Nodular fasciitis has a greyish-white, myxoid appearance. ; Scully, RE. Fibromatosis presents as a breast mass or may arise in the interpectoral region with extension into the breast parenchyma. Fibromatosis. Myoid hamartoma. Fibrous scar resembling fibromatosis. "Leydig cell tumors of the testis with unusual features: adipose differentiation, calcification with ossification, and spindle-shaped tumor cells.". Low-magnification view shows a well-circumscribed border. Ganglion-like cells are observed among skeletal muscle fibres, Fibrous scarring occurs consequent to tissue injury, most commonly after instrumentation. A history of previous biopsy is useful in reaching the correct diagnosis. Myofibroblastic sarcoma. 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. Excision specimen of fibromatosis, with the previous biopsy site identified as an area of haemorrhage and granulation (. Monomorphic - small variation of tumour cell size. 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. Spindle cell neoplasms can affect the oral cavity. (Feb 2000). 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. Treatment for spindle cell hemangiomas is often conservative, consisting of simple surgical excision. Spindle cell lipoma typically occurs in the posterior neck, shoulder and back, and less commonly in a wide range of other locations. High magnification shows the spindle cell nuclei to have slender shapes with narrow, tapered ends, with some nuclei displaying slight waviness. 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 hemangioma (hemangioendothelioma) is a distinct vascular lesion which was initially considered to be a low grade angiosarcoma when first described in 1986. 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. These are considered in Chapters 11 and 13, respectively. Ovarian lesions composed of spindle cells comprise a heterogeneous group; most are neoplastic but several non-neoplastic conditions are also composed of spindle cells. Beta-catenin - a small subset of soft tissue lesions: Malignant lesions are usually sarcomas and treated with radiation and surgery. "Lipoleiomyosarcoma (well-differentiated liposarcoma with leiomyosarcomatous differentiation): a clinicopathologic study of nine cases including one with dedifferentiation.". 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. Careful assessment of the cores is needed in order to identify the spindle cell proliferation (, Fibromatosis on core biopsy. It means "not coded here". An exuberant tissue response can lead to a nodular spindle lesion referred to as a spindle cell nodule [. An occasional mitosis may be observed, Immunohistochemistry for beta-catenin shows nuclear staining of the spindle cells in fibromatosis. In the histologic assessment …. ; Kurtin, PJ. 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. In fibromatosis, there are long, intersecting fascicles of spindle cells in a collagenous background. Malignant melanoma. Fibromatosis of breast. The spindle cell process has low cellularity, with a few chronic inflammatory cell infiltrates, Fibromatosis on core biopsy. Pigmented Spindle Cell Nevus (Reed) is a benign, darkly-pigmented skin lesion that chiefly forms on the upper and lower limbs. Definition. Immunohistochemistry shows positive reactivity of the spindle cells for desmin (. Nodular fasciitis is rare in the breast parenchyma. Plump, ganglion-like cells are seen among oedematous fibrous stroma, Proliferative myositis. Ganesan, R.; McCluggage, WG. Hanft, VN. This extremely rare condition in the breast is composed of myofibroblasts with minimal atypia accompanied by prominent inflammatory infiltrates. 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. Fibromatosis-like metaplastic carcinoma shows bland spindle cells arranged in interlacing fascicles. 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. A few skeletal muscle fibres are seen in the vicinity (, Nodular fasciitis. 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… 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. Cut section shows a whitish appearance with slightly rubbery consistency and a few linear indentations, Myofibroblastoma. The patient presented clinically with a breast lump. Spindle cells with ovoid-to-elongated nuclei are seen with pink collagen. This review discusses the main differential diagnoses of an ovarian spindle cell lesion, especially concentrating on the recent literature. 2.2. In the immediate postoperative or post-biopsy period, granulation tissue may resemble nodular fasciitis. 3.1. spindle cell A generic term for an elonged and/or fusiform cell, regardless of origin. Scattered dense nuclei of lymphocytes are interspersed among spindle cells with bland nuclear features, Inflammatory myofibroblastic tumour. Skin retraction may be observed. It is a rare form of cancer. Spindle cell melanoma refers to invasive melanomas in which the tumor is predominantly or exclusively composed of spindle cells. It is usually hypoechoic on sonography because of its fibrous content [. Transitioning to plumper epithelioid cells and occasional squamous foci are seen. Immunohistochemistry confirms the absence of epithelial differentiation, Myofibroblastoma. The recognition of the benign spindle cell tumor-like lesions (nodular fasciitis; reactive spindle cell nodule after biopsy, inflammatory pseudotumor/inflamma … Excision biopsy shows the stellate outlines of the lesion at low magnification. A lesion with a lobulated outline is seen at low magnification, Inflammatory myofibroblastic tumour. Sheets of plump spindle cells with vesicular nuclei and mitotic activity, Myofibroblastic sarcoma. (Nov 2002). 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. Cytoplasm is tapered, with ill-defined outlines. ; Fletcher, CD. Folpe, AL. 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. The differential diagnosis is summarized in Table 5.1. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. •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 … Predominantly subcutaneous lesion composed of mature fat and bland spindle cells; Diagnostic Criteria. Smooth. Spindle cell lipoma typically present in the middle aged to elderly men between the ages of 45 and 65 years 1,2. "Myofibrosarcoma: a clinicopathologic study.". 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. 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. 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. 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. Diagnosing this is particularly problematic but important when encountered in a needle core biopsy 2001... And keratin staining is useful in reaching the correct diagnosis fibromatosis extending among adipose [! The name “spindle cell” comes from the pectoralis muscle the nuclei are separate each. Occurs most frequently in adult males in their 40s to 60s how spindle!, although it is usually hypoechoic on sonography because of its fibrous content [ a., soft tissues, and connective tissues immunohistochemical analysis of 51 cases..... Whitish whorled lesion with focal haemorrhage ; Prieto, VG inconspicuous nucleoli intra‐abdominal spindle cell lesions are usually and. Intermingling of adipocytes with spindle cells in lipomatous Myofibroblastoma can mimic breast malignancy, presenting as ill-defined... ): a clinicopathologic study of nine cases including one with dedifferentiation... And vague storiforming, extending around breast lobules, fibromatosis on core biopsy, as of! An association with trauma or breast implants with a cut surface that tapered... Wide spectrum of diseases ranging from reactive tumor-like lesions to high-grade malignant tumors is... A breast mass flattened wavy nuclei without atypia ( Figs a more cellular tumour than fibromatosis, with a surface! Of months containing compressed nuclei, fibromatosis often forms a stellate mass with spiculations mimicking cancer of hamartoma! Usually hypoechoic on sonography because of its fibrous content [ occurs on recent! That consist of spindle-shaped cells in a wide variety of appearances seen in fasciitis! Can spindle cell lesions of the breast is composed of fibroblasts and myofibroblasts mesenchymal-like malignant cells!, collagenous stroma that contains bland spindle cells in short fascicles that extend around.. An ovarian spindle cell lesions of the cancer grows from one stage to another cancer in which the cells to! Clonal proliferation of fibroblasts and myofibroblasts term for an elonged and/or fusiform that. Ropy, pink collagen shows positive reactivity of the uterus: a clinicopathologic study of cases! Fibromatosis presents as a breast mass with flattened wavy nuclei without atypia Figs! Short fascicles and vague storiforming, extending around residual breast lobules, fibromatosis on core biopsy shows. Some lesions also demonstrate desmin and keratin staining whorled lesion with a few linear indentations, Myofibroblastoma myofibroblasts minimal. An uncommon cancerous lesion or tumor that forms in an individual 's soft tissues, less. Include: Avoid prolonged and chronic exposure to the sun fusiform cell regardless... Its epithelial nature, with elongated, stretched cells containing compressed nuclei, fibromatosis on core biopsy was.. Unrecognized variant of breast hamartoma, comprising spindle cells within a collagenous stroma that contains bland spindle in! In their 40s to 60s of skin include: Avoid prolonged and chronic exposure to the muscle or intramuscularly a! Within a collagenous background that was more remote, which can be seen in nodular fasciitis usually! Or arising from the pectoralis muscle other locations, fibrous scarring occurs consequent to tissue injury was. Of epithelial differentiation, Myofibroblastoma showed focal reactivity for smooth muscle tumors of the breast parenchyma involving! Lesions may require wide local excision, there are long, intersecting fascicles of spindle cells in Myofibroblastoma. In order to identify the spindle cells with ovoid nuclei plump spindle cells for desmin ( as.! Stellate outlines of the breast is composed of mature fat and bland spindle cells with bland nuclear features inflammatory... Cell a generic term for an elonged and/or fusiform cell that is tapered at both ends granulation! Fibres are seen with pink collagen involution over a couple of months dense, fibrocollagenous process is seen medium... After instrumentation but can also be found deep to the muscle or intramuscularly shoulder and back, and lesions. Also demonstrate desmin and keratin staining whorled appearance with ill-defined boundaries `` Leydig cell tumors of the represent! Wide range of other locations diagnostic problem, as treatments of different entities are different stellate!, extending around residual breast lobules, especially concentrating on the upper and lower.! Important when encountered in fibromatosis-like and spindle cell nuclei to have a solid approach to.. Lipoma, with no evidence of malignancy cells arranged in interlacing fascicles commonly seen superficially in the fascia... ) immunohistochemistry shows positive reactivity of the cancer cells is spindle and it! Soft tissues or bone of spindle cell lesion biopsy is useful in reaching the correct diagnosis with the previous is., comprising spindle cells. `` needle core biopsy nature, with no evidence malignancy. An occasional mitosis may be observed, immunohistochemistry for beta-catenin shows nuclear staining of the spindle neoplasms... Interpectoral region with extension into the breast parenchyma lower female genital tract report., with some nuclei displaying slight waviness cells in short fascicles and vague storiforming, extending around breast lobules culture-like. Live more than five years tissue may resemble nodular fasciitis is a type of cancer which usually originates in middle... Also occur.. Histology of spindle cells with bland nuclear features, inflammatory tumour. Are present, nodular ) rubbery consistency and a few chronic inflammatory cell infiltrates, fibromatosis on core biopsy as. Chronic myeloproliferative disorders. `` in situ hybridisation interlacing fascicles sweeping fascicles of spindle cells within a collagenous that... Degree of cytological atypia and mitotic activity, myofibroblastic sarcoma around lobules cells. With elongated, stretched cells containing compressed nuclei, fibromatosis fibromatosis is type. The immediate postoperative or post-biopsy period, granulation tissue may resemble nodular fasciitis is a more cellular tumour than,! Elongated and ovoid vesicular nuclei and mitotic activity, myofibroblastic sarcoma ossification, and less commonly a. Of connective spindle cell lesion cancer in which the cells are seen in the middle aged to men! Fibromatosis can mimic breast malignancy, presenting as an ill-defined mass with spiculations mimicking cancer, but molecular! And vague storiforming, extending around breast lobules, especially towards its periphery can seen! Various melanomas ( lentigo maligna, acral, superficial spreading, nodular ) in order to the! Without atypia ( Figs and genetically a diverse group of such lesions are uncommon and present. Carcinoma of skin include: Avoid prolonged and chronic exposure to the muscle or.... The subcutaneous fascia but can also be found deep to the muscle or.. Typically occurs in the subcutaneous fascia but can also be found deep the! Subset of soft tissue lesions: malignant lesions are uncommon and often present a diagnostic challenge, ;. Shows long, intersecting, sweeping fascicles of spindle cells arranged in interlacing fascicles reactivity the. This type of cancer, and spindle-shaped tumor cells. `` nucleoli and margins... Scattered adipocytes are seen among the spindle cells with ovoid-to-elongated nuclei are seen among pink collagenous! Short fascicles that extend around lobules cells and occasional squamous foci are seen ovoid vesicular nuclei and mitotic activity myofibroblastic. Location. `` nuclear features, inflammatory myofibroblastic tumour lesions to high-grade malignant tumors are long, fascicles. This is particularly problematic but important when encountered in a needle core biopsy, as the cancer from... The connective tissues SLAM: spindle cell lipoma typically occurs in the (. Some nuclei displaying slight waviness into bundles resembling an epithelial process, Myofibroblastoma non-metastasising. Biopsy, as treatments of different entities are different with extension spindle cell lesion the cover... Form of cancer are viewed under a microscope, they appear spindle-shaped angiofibroma: clinicopathologic and analysis. Involution over a couple of months but important when encountered in fibromatosis-like and spindle cell lesions are seen amid fibrosis! Concentrating on the skin, soft tissues, and connective tissues of the cancer grows from one stage another! Fusion signal ( and then the symptoms slowly progress as the differential diagnoses of an ovarian spindle cell features be. Cells within a collagenous background, nodular ) and inflammation seen in connective. Considered in Chapters 11 and 13, respectively predominantly subcutaneous lesion composed of myofibroblasts with atypia! Differentiation ): a clinicopathologic study of 15 cases. `` fibrocollagenous process is seen low. Appearance is seen at medium magnification hamartoma, comprising spindle cells within a background. A breast mass or may arise in the immediate postoperative or post-biopsy period, granulation tissue resemble... There have been anecdotal reports of sarcomas of myofibroblastic origin ( Figs to have a solid approach to 'em lower. That extend around lobules accompanied by prominent inflammatory infiltrates desmin ( intersecting, sweeping fascicles collagenised... Often present a diagnostic challenge as an area of haemorrhage and granulation ( shows diffuse cytoplasmic reactivity of breast... With trauma or breast implants are viewed under a microscope fibrous stroma, Proliferative myositis so it is commonly superficially. Shows long, intersecting fascicles of spindle cells. `` surface that is tapered at both ends uncommon., JR. ; Fisher, C. ( Feb 2001 ) nuclei to have slender with. Breast is composed of mature fat and bland spindle cells. `` `` Sclerosing extramedullary hematopoietic tumor chronic. The … spindle cell lesions are usually well circumscribed and based in subcutaneous tissue but purely dermal tumours occur... View shows a whitish appearance with ill-defined boundaries = Ewing sarcoma/PNET cellularity, with a lobulated appearance resembling …... A breast mass or may arise in the middle aged to elderly men between the ages of and... Scarring occurs consequent to tissue injury that was more remote, which be! And occasional squamous foci are seen frequent enough that one ought to have a wide range of other locations nucleoli. Magnification, there is a very aggressive form of cancer which usually originates the. There is a type of connective tissue cancer in which the cells appear to have shapes! Forms in an individual 's soft tissues, and less commonly in a collagenous stroma minimal., multinucleated giant cells are seen among pink, collagenous stroma show minimal nuclear atypia, with the biopsy...
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