scholarly journals The Most Common Mistake in Laryngeal Pathology and How to Avoid it

2021 ◽  
Author(s):  
Amin Heidarian ◽  
Bruce M. Wenig
Keyword(s):  
Spindle Cell ◽  
Sarcomatoid Carcinoma ◽  
Squamous Carcinoma ◽  
Epithelioid Cell ◽  
Upper Aerodigestive Tract ◽  
Laryngeal Pathology ◽  
Common Mistake ◽  
Pathologic Features ◽  
Spindle Cell Proliferation ◽  
Made In

AbstractUpper aerodigestive tract (UADT) spindle cell squamous carcinoma (SCSC), also known as sarcomatoid carcinoma, is a high-grade subtype of conventional squamous cell carcinoma (SCC) that is histologically characterized by a combination of differentiated SCC in the form of intraepithelial dysplasia and/or invasive differentiated SCC, and the presence of an invasive (submucosal) undifferentiated malignant spindle-shaped and pleomorphic (epithelioid) cell component. Typically, SCSC presents as a superficial polypoid mass not infrequently with surface ulceration precluding identification of an intraepithelial dysplasia. Further, in many cases an invasive differentiated SCC is not identified. Adding to the complexity in such cases, is that immunohistochemical staining in a significant minority of cases is negative for epithelial-related markers but often the cells express mesenchymal-related markers. In such cases, differentiating SCSC from a reactive (benign) spindle cell proliferation or a mucosal-based sarcoma can be problematic, with treatment implications. Herein, we detail the clinical and pathologic features of laryngeal SCSC and discuss the rationale for diagnosing a carcinoma and avoiding a diagnosis of sarcoma. In our experience, such cases represent one of the more common mistakes made in laryngeal pathology. Yet, virtually all such lesions are SCSCs. The treatment and prognosis relies on the accuracy of this distinction.

Pseudosarcoma of the larynx: the value of ploidy analysis

1994 ◽  
Vol 108 (6) ◽  
pp. 525-528 ◽  
Author(s):  
Michael Cassidy ◽  
Michael Maher ◽  
Peader Keogh ◽  
Mary Leader
Keyword(s):  
Cell Carcinoma ◽  
Spindle Cell ◽  
Squamous Carcinoma ◽  
Spindle Cell Carcinoma ◽  
Positive Staining ◽  
Invasive Squamous Cell Carcinoma ◽  
Dna Index ◽  
Clinical Recurrence ◽  
Ploidy Analysis ◽  
Spindle Cell Proliferation

AbstractAn 82-year-old male presented with a two-month history of hoarseness. A 2 cm pedunculated lesion was removed from the base of his epiglottis. Microscopy showed a polypoid atypical spindle cell lesion. Multiple levels failed to reveal an invasive squamous cell carcinoma. On the basis of haematozylin and eosin stained sections the main differential diagnosis was a pseudosarcoma with an overlying dysplastic squamous mucosa or infiltrating spindle cell carcinoma. Immunohistochemistry showed positive staining for vimentin but no convincing staining with antibodies to cytokeratin and EMA. Ultrastructural analysis also failed to reveal epithelial characteristics. Ploidy analysis by static cytophotometry of the spindle cell proliferation revealed an aneuploid stem line with a DNA index of 1.67. On the basis of this the process was felt unlikely to be reactive and a diagnosis of a spindle cell squamous carcinoma was made. This diagnosis was subsequently supported by a clinical recurrence of the nodule at a six-month follow-up.

Pigmented Perivascular Epithelioid Cell Tumor of the Kidney

2009 ◽  
Vol 133 (12) ◽  
pp. 1981-1984 ◽  
Author(s):  
Masaharu Fukunaga ◽  
Tohru Harada
Keyword(s):  
Tumor Cells ◽  
Spindle Cell ◽  
S100 Protein ◽  
Epithelioid Cell ◽  
Cell Tumor ◽  
Cell Renal Cell Carcinoma ◽  
Perivascular Epithelioid Cell Tumor ◽  
Perivascular Epithelioid Cell ◽  
Spindle Cell Proliferation ◽  
Clear Cytoplasm

Abstract A case of pigmented perivascular epithelioid cell tumor of the kidney in a 57-year-old woman with a clinically indicated tuberous sclerosis is presented. The lesion was a 3.0-cm, well-demarcated, black-colored mass. The tumor was histologically characterized by an epithelioid arrangement of round to polygonal cells with round nuclei and clear cytoplasm containing abundant melanin. Tumor cells showed mild atypia and low mitotic activity. A spindle cell proliferation was focally observed. There were no adipose elements or thick-walled vascular vessels. The stroma demonstrated intervening, thin, fibrovascular septa. Immunohistochemically, the tumor cells were strongly positive for HMB-45 but negative for epithelial and muscle markers, vimentin, and S100 protein. The patient had no evidence of disease 3 months after surgery. Pathologists and clinicians should know about the existence of pigmented perivascular epithelioid cell tumor of the kidney. This type of tumor should be differentiated from clear cell renal cell carcinoma or malignant melanoma.

Basaloid Squamous Carcinoma of the Hypopharynx With an Extensive Spindle Cell Component Exhibiting a Pedunculated Polypoid Mass

2005 ◽  
Vol 129 (4) ◽  
pp. e94-e96
Author(s):  
Tokuhiro Kimura ◽  
Makio Mukai ◽  
Akihiro Shiotani ◽  
Kazuhisa Moro ◽  
Asako Ikeda ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Spindle Cell ◽  
Squamous Carcinoma ◽  
Polypoid Mass ◽  
Cell Component ◽  
Histologic Diagnosis ◽  
Spindle Cell Component ◽  
Basaloid Squamous Carcinoma ◽  
Spindle Cell Proliferation ◽  
Basaloid Squamous

Abstract We report a case of basaloid squamous carcinoma of the hypopharynx with an extensive spindle cell component in an 82-year-old man. The tumor (4.0 × 2.5 × 2.2 cm) was a pedunculated polypoid mass that was attached to the left pyriform sinus. Histologically, most (70%) of the tumor was composed of malignant spindle cell proliferation, and the rest (30%) was basaloid squamous carcinoma. Some of the spindle cells were positive for cytokeratins. The preoperative histologic diagnosis was difficult because the endoscopic biopsy specimens showed only spindle cell proliferation. This is an unusual presentation of basaloid squamous carcinoma of the head and neck.

Precursor Lesions for Squamous Carcinoma in the Upper Aerodigestive Tract

2021 ◽  
pp. 1-62
Author(s):  
Edward Odell ◽  
Nina Gale ◽  
Selvam Thavaraj ◽  
Alfons Nadal ◽  
Nina Zidar ◽  
...  
Keyword(s):  
Squamous Carcinoma ◽  
Aerodigestive Tract ◽  
Precursor Lesions ◽  
Upper Aerodigestive Tract

Sarcomatoid Carcinoma of the Small Intestine: A Case Report and Review of the Literature

2004 ◽  
Vol 128 (8) ◽  
pp. 918-921
Author(s):  
Michelle Reid-Nicholson ◽  
Muhammed Idrees ◽  
Giorgio Perino ◽  
Prodromos Hytiroglou
Keyword(s):  
Small Bowel ◽  
Epithelial Membrane Antigen ◽  
Spindle Cell ◽  
English Literature ◽  
Sarcomatoid Carcinoma ◽  
Giant Cells ◽  
Intestinal Wall ◽  
Cytokeratin 20 ◽  
Spindle Cells ◽  
Immunohistochemical Stains

Abstract Sarcomatoid carcinoma of the small bowel is rare; to our knowledge, 19 cases have been reported to date in the English literature under several names. We report an additional case occurring in the jejunum of a 55-year-old man. The tumor was a polypoid 7.5-cm mass, which infiltrated the full thickness of the intestinal wall and the serosa of an adhesed loop of small bowel. On microscopic examination, the neoplasm was composed of sheets of spindle cells; focally, an anaplastic component was present, including tumor giant cells with bizarre nuclei. On immunohistochemical stains, tumor cells were positive for cytokeratin 7, cytokeratin AE1/AE3, vimentin, and focally, epithelial membrane antigen. No staining for cytokeratin 20 was found. Sarcomatoid carcinoma must be kept in mind in the differential diagnosis of malignant spindle cell tumors of the small bowel. As consensus regarding the terminology of these rare tumors is being reached, immunohistochemical stains are essential for accurate diagnosis.

Malignant Ameloblastoma, Spindle Cell Variant

2003 ◽  
Vol 127 (3) ◽  
pp. 352-355
Author(s):  
Richard J. Zarbo ◽  
Mark T. Marunick ◽  
Robert Johns
Keyword(s):  
Spindle Cell ◽  
Intracranial Extension ◽  
Low Grade ◽  
Epithelial Proliferation ◽  
American Girl ◽  
Spindle Cell Proliferation ◽  
Histologic Pattern ◽  
Cell Variant ◽  
Well Differentiated ◽  
African American Girl

Abstract In this report, we document the histologic and clinical features of a previously undefined spindle cell variant of ameloblastoma that eventually behaved in a malignant fashion during a protracted course. The predominant histologic pattern was a well-differentiated, cellular, spindled epithelial proliferation arising in the maxilla of a 14-year-old African American girl. Over 19 years, the patient experienced numerous local recurrences, metastases to distant bones after 15 years, and finally bulky local recurrence with intracranial extension resulting in death. This ameloblastic malignancy histologically simulates a low-grade true sarcoma or an ameloblastic sarcoma, but differs in that the extensive spindle cell proliferation is epithelial, characterized by strong cytokeratin immunoreactivity and negative vimentin staining.

scholarly journals Cytokeratin-positive interstitial reticulum cell (CIRC) tumor in the lymph node: a case report of the transformation from the epithelioid cell type to the spindle cell type

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Sachiko Kaji ◽  
Nobuyuki Hiruta ◽  
Daisuke Sasai ◽  
Makoto Nagashima ◽  
Rintaro Ohe ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Lung Carcinoma ◽  
Spindle Cell ◽  
Small Cell Lung Carcinoma ◽  
Epithelioid Cell ◽  
Small Cell ◽  
Cell Type ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Spindle Cell Type

Abstract Background Cytokeratin-positive interstitial reticulum cells (CIRCs), which are a subgroup of fibroblastic reticular cells (FRCs), are known to be present in the lymph nodes. There have been only a few cases of tumors derived from CIRCs. Case presentation We have reported a new case involving a CIRC tumor in a 75-year-old man and reviewed the literature. The resected mediastinal lymph nodes showed epithelial-like proliferation of large atypical round and polygonal epithelioid cells. The tumor cells expressed CK8, CK18, CAM5.2, AE1/AE3, epithelial membrane antigen, vimentin, fascin, and some FRC markers, which is consistent with the diagnosis of a CIRC tumor. Following chemotherapy, the CIRC tumor was observed to have responded very well and became difficult to confirm on imaging, but a small cell lung carcinoma developed 12 months later. Chemoradiotherapy was performed, but the patient passed away 29 months after the initial diagnosis. The autopsy revealed the recurrence of the CIRC tumor, residual small cell lung carcinoma, and a very small latent carcinoma of the prostate. The relapsed CIRC tumor cells had a spindle shape; they were highly pleomorphic and had invaded the superior vena cava. Conclusion We first reported autopsy findings of CIRC tumors and demonstrated the transformation of the tumor from the epithelioid cell type to the spindle cell type.

scholarly journals Aggressive Monophasic Sarcomatoid Carcinoma of Small Intestine - A Rare Case Report With Review of Literature

2012 ◽  
Vol 02 (01) ◽  
pp. 45-47
Author(s):  
Shetty K. Padma ◽  
Harish S. Permi ◽  
C.N. Patil ◽  
Michelle Mathias
Keyword(s):  
Small Intestine ◽  
Rare Case ◽  
Spindle Cell ◽  
Correct Diagnosis ◽  
Sarcomatoid Carcinoma ◽  
Intestinal Wall ◽  
Cell Tumor ◽  
Review Of Literature ◽  
Spindle Cells ◽  
Rare Case Report

AbstractSarcomatoid carcinoma occurring in the small intestine is very rare. They can be monophasic or biphasic. We report a rare case of monophasic Sarcomatoid carcinoma of the small intestine in a 60 year old male patient. The tumor was an ulceronodular mass involving the ileum circumferentially. The tumor infiltrated the full thickness of the intestinal wall and the serosa of an adjacent loop of ileum. Microscopically, the tumor was composed of sheets of malignant spindle cells. The carcinomatous nature of the tumor was evident only after Immunohistochemistry. The diagnosis of sarcomatoid carcinoma should be considered in the differential diagnosis of malignant spindle cell tumor of small intestine and immunohistochemical stains are required for the correct diagnosis.

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