Spindle-cell carcinoma of the oral cavity and larynx. Immunohistochemical aspects.
Five cases of monophasic and 7 cases of biphasic spindle-cell carcinomas were analyzed immunohistochemically for the presence of vimentin and keratin type intermediate filaments in the pleomorphic spindle cells. Vimentin reactivity proved to be a consistent feature but keratin reactivity was more variable, this latter filament being lost in two cases initially presenting as pure squamous cell carcinomas showing dedifferentiation towards a pure monophasic spindle-cell tumour when recurring. The converse was also noted: acquisition of keratin in a monophasic spindle-cell tumour that recurred as squamous cell carcinoma. These results were considered to support the concept that spindle-cell tumours of the upper aerodigestive tract are a peculiar type of carcinoma and not a product of a pluripotent stem cell exhibiting bidirectional differentiation. Diagnostic implications are as follows: keratin positivity in a spindle-cell tumour substantiates its carcinomatous nature but its absence does not rule out a diagnosis of spindle-cell carcinoma.
Slootweg
P J
PJ
Pathology Institute, University of Utrecht, The Netherlands.
Roholl
P J
PJ
Müller
H
H
Lubsen
H
H
D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000032:analysis / Q000473:pathology* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000032:analysis / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D007822:Laryngeal Neoplasms / Q000032:analysis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000032:analysis / Q000473:pathology*; D009364:Neoplasm Recurrence, Local; D014746:Vimentin / Q000032:analysis
D014746:Vimentin; D007633:Keratins