Low power view of the patient's initial specimen from 1988, which reveals a predominately bland appearing spindleĬell neoplasm, with areas of clear cells.įigure 2. Not improve, and he continued to become more dyspneic with a decreased mental status throughout. After the procedure, the left lung expanded, but there were numerous areas of atelectasis. Later that year the patient was noted to have persistent pleural effusion, which was aspirated yielding 3 liters of serosanguinousįluid. Parietal pleura, and pleurectomy for tumor debulking from the diaphragmatic surface (Figs. He was also experiencing bone pain all over his body, bloodĪs a diagnostic and treatment procedure, he underwent left exploratory thoracotomy, and excisional biopsy of the implant in The patient experienced 10-pound weight loss within the 4 weeks. Metastatic disease of primary neuroendocrine differentiation. However, the results of an OctreoScan argued against (FNA) this was interpreted as a possible carcinoid tumor (Figs. At that time,īoth a chest x-ray and CT scan were performed, revealing a left lower lung lobe tumor on bronchoscopy and fine needle aspiration At approximately the same time he started experiencing hematuria. Pain initially began after a car accident. In 2001, at the age of 71, this patient presented to our clinic with a chief complaint of chest pain. 3), diagnosis of prostate cancer was confirmed and a prostatectomy was performed (Fig. In 1999 he was found to have an elevated PSA (prostate specific antigen) and an abnormal digital-rectal exam. No further therapy was performed at that time. The working diagnosis was that of a neoplasm of endocrine or neuroendocrine The mass was well circumscribed and was considered to be a lymph node replaced either by metastatic He underwent an excisional biopsy, which revealedĪ 3-cm firm nodular lesion. In 1988 a 58-year-old white man noticed a lump in his right axillary region. We discuss the immunophenotype, differential diagnosis,Īnd molecular signatures of these neoplasms, and review the pertinent literature on these entities. The clinician, because proper diagnosis ultimately influences treatment. It is the role of pathologists, particularly dermatopathologists, to distinguish CCS from malignant melanoma, and to alert Peripheral nerve sheath tumor, and a category of so-called PEComas. The histopathologicĪnd immunohistochemical profile of this melanocytic neoplasm was diagnostic of clear cell sarcoma (CCS) of tendons and aponeuroses,Īlthough the differential diagnosis included malignant melanoma, follicular dendritic and interdigitating cell tumors, malignant (14-years post initial diagnosis), the case was reviewed and the possibility of metastatic melanoma was raised. After subsequent development of a pulmonary nodule in 2001 Neoplasm there was no history of a primary cutaneous malignancy. Of Pittsburgh Physicians, Department of Pathology AbstractĪ patient initially presented in 1988 with a solitary axillary mass, diagnosed as a high-grade neuroendocrine spindle-cell University of Pittsburgh Physicians, Department of Dermatology University University of Pittsburgh School of Medicine2.

Lori Spencer PhD 1, and Drazen Jukic MD, PhD 1, 2 Dermatology Online Journal 10 (1): 8 1. A 71-year-old man with spindle-cell neoplasm of unknown origin: A difficult-to-diagnose clear-cell sarcoma Vimentin, SMA, and calponin positivity proved the sarcomatous component with myoepithelial differentiation. In addition, p63 positivity is indicated the squamous differentiation. Positivity of EMA and pancytokeratin revealed the epithelial origin of the tumor. In immunohistochemical staining, atypical stromal cells were stained positive with vimentin, pancytokeratin (cytokeratin AE1/AE3), epithelial membrane antigen (EMA), smooth muscle actin (SMA), CD99, p63, and calponin and were stained negative with caldesmon and MyoD1. The stroma was rich in atypical cells forming herds and bundles of spindle or epithelioid cells, with hyperchromatic nuclei and pleomorphism mixed with inflammatory cells.

Histopathologic evaluation revealed in situ carcinoma which holds the whole conjunctival squamous epithelium with significant polarity loss, nuclear enlargement with hyperchromasia and pleomorphism, and mitotic activity. Clinical picture of a large vascularized lesion located in superior bulbar conjunctiva with extension onto the cornea

Spindle cell carcinoma