Esophageal carcinoma with prominent spindle cells

Abstract

Eight cases of esophageal carcinoma with prominent spindle cells (carcinosarcoma or pseudosarcoma) were studied using the avidin-biotin immunoperoxidase method and monoclonal antibodies to various keratins and vimentin. In all eight cases positive immunoreactivity for keratin was found in carcinomatous areas and for vimentin, in the spindle cells. It is interesting that five cases demonstrated focal immunoreactivity to keratin in the spindle cell component. Trace positivity to vimentin was seen in the carcinomatous areas in one case. These findings are consistent with the hypothesis that esophageal carcinoma with prominent spindle cells is of epithelial origin and may represent a morphologic variant of squamous cell carcinoma.

Carcinosarcoma and Pseudosarcoma of the Esophagus: Two Names, One Disease—Comprehensive Review of the Literature

“…Wang et al [36], Gal et al [25], and Kuhajda et al [45] interpreted their findings as consistent with the hypothesis of the epithelial origin. Immunohistochemical studies demonstrated that not only mesenchymal cells but also small numbers of poorly differentiated epithelial tumors, could express vimentin or co-express vimentin and keratin [55][56][57][58][59].…”

Keratinized Spindle Cell: A Diagnostic Cytological Atypia In Human Oral Carcinoma

“…Possible reasons for the inability to detect keratin are decreased numbers of cells producing keratin, decreased amount of keratin within these cells, and decreased immune-reactivity of the keratin due to formalin fixation. Thus, a positive keratin stain confirms the diagnosis of squamous cell carcinoma, but a negative result does not rule it out [23,24]. Takata et al have also opined that SpCC should not be ruled out of the differential diagnosis by a positive reaction for vimentin in sarcomatoid tumour cells in the immunohistochemical differential diagnosis.…”

Evidence for colorectal sarcomatoid carcinoma arising from tubulovillous adenoma

“…Other investigators suggest a clonal origin (monoclonal hypothesis) of the tumor since common characteristics have been seen between the different cellular populations as well as an observed transitional population [25,26] . For example, the presence of cytokeratin in spindle cells within sarcomatoid carcinomas of various anatomical locations supports the epithelial origin of these cells [17,19,27,28] . The observed characteristics in the monoclonal hypothesis could either be due to a malignant transformation of a pluripotent stem cell capable of epithelial and mesenchymal differentiation or the sarcomatous element arising from a metaplastic transformation of the carcinomatous element.…”