Difference between revisions of "Spindle cell lesions"
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(→Malignant fibrous histiocytoma: wikify) |
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Work-up (MSH): | Work-up (MSH): | ||
*CD34 - [[GIST]], [[angiosarcoma]], [[solitary fibrous tumour]]/[[hemangiopericytoma]], [[Kaposi sarcoma]]. | *CD34 - [[GIST]], [[angiosarcoma]], [[solitary fibrous tumour]]/[[hemangiopericytoma]], [[Kaposi sarcoma]]. | ||
*S100 - neural marker, sensitive for malignant melanoma, Langerhans cells, [[clear cell sarcoma]]. | *S100 - neural marker, sensitive for [[malignant melanoma]], Langerhans cells, [[clear cell sarcoma]]. | ||
*Desmin - smooth muscle. | *Desmin - smooth muscle. | ||
*MIB1 - proliferation. | *MIB1 - proliferation. | ||
*CD99 - immature T cells (thymus), small round cell tumours, [[synovial sarcoma]], merkel cell carcinoma, [[osteosarcoma]].<ref name=Ref_DCHH108>{{Ref DCHH|108}}</ref> | *CD99 - immature T cells (thymus), [[small round cell tumours]], [[synovial sarcoma]], merkel cell carcinoma, [[osteosarcoma]].<ref name=Ref_DCHH108>{{Ref DCHH|108}}</ref> | ||
**Considered "slutty", i.e. non-specific, by Dr. Fletcher; useful if membranous stain pattern = Ewing sarcoma/PNET. | **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.<ref name=Ref_DCHH107>{{Ref DCHH|107}}</ref><ref>URL: [http://ajp.amjpathol.org/cgi/content/full/160/3/759 http://ajp.amjpathol.org/cgi/content/full/160/3/759]. Accessed on: 3 August 2010.</ref> | *BCL2 - [[synovial sarcoma]], [[small cell lymphomas]], spindle cell lipoma.<ref name=Ref_DCHH107>{{Ref DCHH|107}}</ref><ref>URL: [http://ajp.amjpathol.org/cgi/content/full/160/3/759 http://ajp.amjpathol.org/cgi/content/full/160/3/759]. Accessed on: 3 August 2010.</ref> | ||
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*SMMS - smooth muscle. | *SMMS - smooth muscle. | ||
*Caldesmon - muscle. | *Caldesmon - muscle. | ||
*PDGFR - GIST | *PDGFR - [[GIST]] | ||
*DOG-1 - GIST (membranous, cytoplasmic),<ref name=pmid19417627>{{cite journal |author=Ardeleanu C, Arsene D, Hinescu M, ''et al.'' |title=Pancreatic expression of DOG1: a novel gastrointestinal stromal tumor (GIST) biomarker |journal=Appl. Immunohistochem. Mol. Morphol. |volume=17 |issue=5 |pages=413–8 |year=2009 |month=October |pmid=19417627 |doi=10.1097/PAI.0b013e31819e4dc5 |url=}}</ref> normal pancreas (islets),<ref name=pmid19417627/> associated with BRCA1. | *DOG-1 - GIST (membranous, cytoplasmic),<ref name=pmid19417627>{{cite journal |author=Ardeleanu C, Arsene D, Hinescu M, ''et al.'' |title=Pancreatic expression of DOG1: a novel gastrointestinal stromal tumor (GIST) biomarker |journal=Appl. Immunohistochem. Mol. Morphol. |volume=17 |issue=5 |pages=413–8 |year=2009 |month=October |pmid=19417627 |doi=10.1097/PAI.0b013e31819e4dc5 |url=}}</ref> normal pancreas (islets),<ref name=pmid19417627/> associated with BRCA1. | ||
Revision as of 15:39, 1 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.