spindle cell tumor
Introduction
Introduction to spindle cell tumor Cellular tumors are mainly spindle cells, which can occur in any organ or tissue, and the morphological manifestations can be cancer or tumor. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: bloating, abdominal pain
Cause
Spindle cell tumor etiology
There are many types of tumors based on spindle cells. In addition to sarcoma, there are some cancers and malignant melanomas. When the degree of cell differentiation is low, it is often difficult to diagnose tissue types. When observing the slice for differential diagnosis, you can start from the following aspects and analyze it layer by layer.
1. First, it is possible to analyze the sarcoma, cancer or malignant melanoma from the location of the tumor and the age of the patient. Low-differentiated soft tissue sarcoma and malignant peripheral nerve tumors occur mostly in deeper tissues, muscles, retroperitoneum, pelvic, mediastinal and internal organs, and are not closely related to the surface or mucosal epithelium covered by tissue, and poorly differentiated spindle cells. Cancer is more common in organs such as the nasopharynx, esophagus, and bladder that cover the squamous epithelium or transitional epithelium. The tumor is closely related to the epithelium and has ulceration. In addition, spindle cells are also found in organs such as the lungs and thyroid. Malignant melanoma is more common in mucous membranes derived from the skin and ectoderm. Sarcoma is considered more for children and adolescents under the age of 20, and sarcoma and cancer are possible in adults.
2, soft tissue tumors appear more tumor giant cells and odd cells are generally not fibrosarcoma, but should consider rhabdomyosarcoma, liposarcoma, malignant fibrous histiocytoma or leiomyosarcoma, followed by malignant peripheral nerve sheath tumor.
3, the shape and arrangement of spindle cells can provide clues to the tumor tissue type to a certain extent. For example, the cytoplasm of fibrosarcoma cells is usually not as rich as myogenic cells, the cytoplasmic width generally does not exceed the width of the nucleus, the cell boundaries are not as clear as the latter, and the myogenic tumor cells may be long fusiform or banded. Longitudinal fibrils can be seen in the cytoplasm, and the cytoplasmic eosin staining of rhabdomyosarcoma is stronger. The fusiform cell bundles of fibrosarcoma are mostly herringbone, and the carburtic structure is more common in malignant fibrous histiocytoma. It is also seen in other spindle cell sarcomas, but it is less and less typical. The nuclear grid arrangement is not as obvious in the corresponding benign tumors as malignant schwannomas and moderately differentiated leiomyosarcomas, but it is still visible.
4. Carefully search for evidence that the spindle cells are excessive to other morphological cells. If the spindle cells are predominantly sarcoma, if they can find excessive differentiation into rhabdomyoblasts, fat cells, or bidirectional differentiation (synovial sarcoma, malignant Mesothelioma) is classified according to the direction of differentiation.
Prevention
Spindle cell tumor prevention
Strengthen physical exercise, enhance physical fitness, and exercise more in the sun. Excessive sweating can excrete acidic substances in the body with sweat, avoiding the formation of acidic body.
Complication
Spindle cell tumor complications Complications, abdominal distension, abdominal pain
Abdominal distension, abdominal pain, etc. may occur.
Symptom
Spindle cell tumor symptoms Common symptoms Vaginal bleeding dysphagia Gastrointestinal bleeding Bloating
If it occurs in epithelial tissues (such as spindle cell carcinoma, spindle cell squamous cell carcinoma), it can also occur in mesenchymal tissues (such as spindle cell sarcoma, spindle cell stromal sarcoma), which is complex in morphology and more like sarcoma, or With the interstitial component resembling sarcoma, the immunophenotype can be expressed as cancer, or as a sarcoma, or as a type of tumor of carcinosarcoma structure. The lesion is difficult to directly examine, and various tests such as immunohistochemical markers are required.
Examine
Spindle cell tumor examination
Immunohistochemistry, special staining or electron microscopy can be performed.
Diagnosis
Diagnosis of spindle cell tumor
diagnosis
Spindle cell tumors can occur in any organ or tissue. Histopathology has large morphological variations in tumor cells. HE staining alone makes it difficult to determine the source of tumor cells, which brings certain difficulties to diagnosis. In order to deepen the pathological understanding of such tumors, reduce medical disputes caused by diagnostic errors, and improve the diagnosis rate. HE staining, immunohistochemical staining, combined with clinical data, retrospective analysis of spindle cell tumors, to explore its clinicopathological features, immunohistochemical markers, provide a basis for diagnosis and differential diagnosis.
Differential diagnosis
1. Epithelial spindle cell tumor
Spindle cell carcinoma is sometimes misdiagnosed as a sarcoma due to the expression of non-epithelial markers.
2. Mesenchymal spindle cell tumor
Spindle cell tumors of mesenchymal tissue are sometimes expressed in cytokeratin and need to be differentiated from epithelial-derived cancer.
3. Spindle cell carcinoma sarcoma
Sometimes cytokeratin expression alone is easily misdiagnosed as cancer. It is necessary to combine clinical, lesion, and histomorphological features to comprehensively analyze the diagnosis.
4. Malignant mesodermal mixed tumor and endometrial stromal sarcoma
Malignant mesodermal mixed tumor (carcinosarcoma) composed of spindle cells and uterine mesangial stromal sarcoma, immunohistochemical keratin and vimentin can be expressed, should be noted.
5. Gastrointestinal or extra-gastrointestinal stromal tumors
In the gastrointestinal or extra-gastrointestinal stromal tumors, the morphology of the tumor cells is mainly in the form of spindle cells, epithelioid cells or mixed cells. Gastrointestinal spindle cell tumors are easily misdiagnosed as GIST (gastrointestinal stromal tumors).
