title: Spindle cell rhabdomyosarcoma: a brief diagnostic review and differential diagnosis.
abstract: Spindle cell rhabdomyosarcoma is a rare variant of embryonal rhabdomyosarcoma that has a predilection for young males and most commonly involves the paratesticular region followed by head and neck. Histopathology demonstrates elongated spindle cells with fusiform to cigar-shaped nuclei and indistinct eosinophilic cytoplasm arranged in fascicles or whorls. Although the tumor demonstrates increased cellularity and moderate atypia, the microscopic and architectural patterns can allow this tumor to be confused with multiple entities, such as leiomyosarcoma, spindle cell carcinoma, desmoplastic melanoma, or fibrosarcoma, with important therapeutic implications. Immunohistochemical workup demonstrates sarcomeric differentiation with reactivity for desmin, myogenin, and MyoD1 markers. Compared with other subtypes, the spindle cell variant in children is associated with a favorable outcome; however, in the adult population there does not appear to be any prognostic advantage.
authors.affiliation: Department of Pathology, University of Tennessee Medical Center Knoxville, Knoxville, Tennessee 37920, USA. SCarroll@utmck.edu
authors.forename: Sarah Jayne
authors.initials: SJ
authors.lastname: Carroll
authors.forename: Laurentia
authors.initials: L
authors.lastname: Nodit
mesh_terms: D000328:Adult; D002648:Child; D020732:Cytogenetic Analysis; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D017570:MyoD Protein / Q000378:metabolism; D011379:Prognosis; D018233:Rhabdomyosarcoma, Embryonal / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy
chemical_list: D017570:MyoD Protein; C057363:MyoD1 myogenic differentiation protein