Department of Pathology, Rutgers University, New Jersey Medical School, Newark, N.J, United States of America.
Ann Diagn Pathol. 2022 Oct;60:152018. doi: 10.1016/j.anndiagpath.2022.152018. Epub 2022 Jul 22.
Spindle cell tumors originating in the mediastinum are extremely rare. Due to the profusion of structures and organs located in the mediastinum, a wide variety of spindle cell neoplastic processes can develop in this location. These include various different tumor types including epithelial, vascular, lipomatous, fibroblastic and neural tumors among others. Many of these different tumor types are associated with specific immunohistochemical and molecular genetic profiles that help differentiate them from each other. Although spindle cell morphology has traditionally been associated with mesenchymal neoplasms, in the mediastinum the most common spindle cell tumor is spindle cell thymoma, an epithelial rather than mesenchymal neoplasm. Except for neurogenic tumors originating in the posterior mediastinum, mesenchymal neoplasms are quite rare in mediastinal locations and require clinical correlation to rule out the possibility of a metastasis from an extra-mediastinal soft tissue or somatic sarcoma. Herein we will review the most common types of spindle cell neoplasms that occur in the mediastinum, with particular emphasis in their differential diagnosis and the role of ancillary techniques for diagnosis.
起源于纵隔的梭形细胞肿瘤极为罕见。由于纵隔内存在大量结构和器官，因此在这个部位可以发生各种不同的梭形细胞肿瘤性病变。这些病变包括各种不同的肿瘤类型，包括上皮性、血管性、脂肪性、成纤维细胞性和神经源性肿瘤等。许多不同的肿瘤类型与特定的免疫组织化学和分子遗传学特征相关，这些特征有助于将它们彼此区分开来。尽管梭形细胞形态学传统上与间叶性肿瘤有关，但在纵隔中最常见的梭形细胞肿瘤是梭形细胞胸腺瘤，这是一种上皮性而非间叶性肿瘤。除了起源于后纵隔的神经源性肿瘤外，间叶性肿瘤在纵隔部位相当罕见，需要与临床相关联以排除来自纵隔外软组织或体腔肉瘤转移的可能性。本文将回顾纵隔中最常见的梭形细胞肿瘤类型，特别强调其鉴别诊断以及辅助诊断技术的作用。
