What Is a Spindle Cell Sarcoma?

Spindle cell tumors are mainly spindle cells and can occur in any organ or tissue. The morphological manifestations can be cancer or tumor.

Spindle cell tumor

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Spindle cell tumors are mainly spindle cells and can occur in any

Spindle cell tumors are mainly spindle cells and can occur in any organ or tissue. The morphological manifestations can be cancer or tumor. As happened

There are many types of tumors that are mainly spindle cells. In addition to sarcomas, there are some cancers and malignant melanoma: when the degree of cell differentiation is low, it is often difficult to diagnose tissue types. When observing slices for differential diagnosis, you can start with the following aspects and analyze them layer by layer. (1) Starting from the location of the tumor and the age of the patient, a preliminary analysis of which sarcoma, cancer, or malignant melanoma is most likely. Poorly differentiated soft tissue sarcomas and malignant peripheral nerve tumors mostly occur in deeper tissues of the human body, such as muscles, retroperitoneum, pelvic cavity, mediastinum, and internal organs. They are not closely related to tissue-covered skin or mucosal epithelium and poorly differentiated spindle cells Cancer is more common in organs and tissues that cover squamous epithelium or transitional epithelium, such as the nasopharynx, esophagus, and bladder. Tumors are closely related to the epithelium and ulcers form. In addition, spindle cell carcinoma can also be seen in organs such as lung and thyroid. Malignant melanoma is more common in the skin and ectoderm-derived mucosa. Consider sarcoma in children and adolescents under 20 years of age, while sarcomas and cancer are possible in adults.

(2) Those with more tumor giant cells and odd cells in soft tissue tumors are generally not fibrosarcoma, but rhabdomyosarcoma, liposarcoma, malignant fibrous histiocytoma or leiomyosarcoma should be considered, followed by malignant peripheral nerve sheath tumors.

(3) The morphology and arrangement of spindle cells can provide clues to tumor tissue types to a certain extent. For example, the cytoplasm of fibrosarcoma cells is usually less abundant than that of muscle-derived cells. The width of cytoplasm generally does not exceed the width of the nucleus, and the cell boundaries are not as clear as the latter. The muscle-derived tumor cells can be long spindle-shaped or band-shaped. Longitudinal fibrils can be seen in the cytoplasm, and cytoplasmic eosinophilic staining of rhabdomyosarcoma is stronger. Fibrosarcoma's spindle cell bundles are mostly arranged in a herringbone pattern; car radial structures are more common in malignant fibrous histiocytoma, and are also seen in other spindle cell sarcomas, but less and less typical. Palisade-like arrangement in malignant nerve sheath tumors and moderately differentiated leiomyosarcoma is not as obvious as in the corresponding benign tumors, but it is still visible sometimes.

(4) Carefully look for evidence that the spindle cells are excessive to other morphological cells; if the spindle-shaped sarcoma can find excessive differentiation in the direction of rhabdomyoblasts, adipocytes, etc., or bidirectional differentiation (synovial sarcoma, Malignant mesothelioma), the diagnosis is classified according to the direction of differentiation.

(5) After the above analysis, if it is still difficult to identify the tumor type, immunohistochemistry, special staining or electron microscopy can be used.