#Spindle cell sarcoma skin#

While the chance of obtaining a definitive diagnosis is less than a biopsy, this is a reasonable first step.Īll soft tissue sarcomas have the potential to be locally invasive. A fine needle aspirate with cytology is less invasive and results are available faster than a biopsy. The diagnosis is most accurately achieved with a surgical biopsy. This leaves dogs susceptible to pain and infection.

#Spindle cell sarcoma skin#

In advanced cases, the skin overlying the tumor can ulcerate or break open. More commonly they grow slowly over months or years. They may grow quickly, over the course of a few weeks. As the tumor grows, it can cause difficulty ambulating and/or cause pain. When signs develop, they are usually related to the primary tumor rather than spread. Initially, most dogs have no signs related to the tumor. The extent of the tumor is poorly estimated by feel. While the tumor may feel well defined, they are highly invasive and send microscopic extensions in all directions. They can feel soft or firm and are usually attached to underlying structures. Soft tissue sarcomas typically grow under the skin. Subtypes include fibrosarcoma, hemangiopericytoma, liposarcoma, myxosarcoma, and undifferentiated sarcoma, among others. Different soft tissue sarcomas are grouped together within this larger category because they have similar appearances on biopsy and similar clinical behavior in the patient. French’s laboratory, who also revealed NUT–bromodomain containing 4 gene ( BRD4) translocation, but the analysis was subsequently repeated in our laboratory (by G.P., M.C., and E.B.) successfully by using a commercially available dual-color break-apart probe kit (ZytoLight SPEC NUTM1 CE IVD, ZytoVision, Bremerhaven, Germany) ( Fig. 2 F).Soft tissue sarcomas are tumors of connective tissues. Owing to this unusual morphology, a FISH confirmation of the NUTC diagnosis was requested to Dr.

A diagnosis of NUTC was definitively rendered by also reviewing bronchial biopsy samples it was staged as pT3N2 (IIIB, according to the TNM/American Joint Committee on Cancer criteria ) because of three N1 metastatic lymph nodes and one N2 metastatic lymph node. Subsequent lobectomy with extended lymph node excision revealed a solid tumor with pushing edges of growth, spotty necrosis, and vascular invasion that was composed exclusively of spindle cells arranged in variably intertwining fascicles with up to 15 mitoses per 2 mm 2 but no signs of keratinization ( Fig. 2 A– D).Īccordingly, an IHC assay for NUT protein expression was carried out with the clone C52B1 (Cell Signaling Technology, Danvers, MA) in a 1:50 dilution for 60 minutes after pretreatment with ethylenediaminetetraacetic acid buffer pH9 for 88 minutes and use of the OptiView DAB IHC Detection Kit on the Ventana BenchMark Ultra (Hoffmann-La Roche AG, Basel, Switzerland), which showed widespread nuclear decoration in virtually all tumor cells ( Fig. 2 E) with a speckling appearance of the staining (see Fig. 2 E ). Bronchial biopsy samples were initially diagnosed as squamous cell carcinoma despite the fact that the patient was young and a nonsmoker. Briefly, a 30-year-old white male nonsmoker was admitted to the hospital for sudden thoracic pain owing to a 6.5-cm tumor involving the left lower lobe ( Fig. 1 A) with minimal homolateral pleural effusion and mediastinal lymph node involvement ( Fig. 1 B). Malignant tumors made of spindle cells in the lung usually comprise pleomorphic or spindle cell carcinoma, some intermediate- to high-grade neuroendocrine tumors, and (less frequently) sarcomas (either primary or metastatic), amelanotic melanoma, mesothelioma, or thymus-like tumors, whereas the existence of spindle cell–looking NUTC in the lung was unprecedented.