Spindle cell lesions
Revision as of 18:51, 25 May 2010 by Michael (talk | contribs) (→Malignant fibrous histiocytoma: more notes)
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.
- S100 - neural marker, sensitive for malignant melanoma.
- Desmin - smooth muscle.
- MIB-1 - proliferation.
- CD99 - small round cell tumours, considered "slutty", i.e. non-specific, by Dr. Fletcher; useful if membranous stain pattern = Ewing sarcoma/PNET.
- Bcl-2.
- PGP 9.5.
- SMMS - smooth muscle.
- Caldesmon - muscle.
- PDGFR - GIST.
- DOG-1 - GIST (membranous, cytoplasmic),[1] normal pancreas (islets),[1] associated with BRCA1.