Spindle cell carcinoma of head and neck: an immunohistochemical and molecular approach to its pathogenesis

Gupta, Ruchika ; Singh, Sompal ; Hedau, Suresh ; Nigam, Sonu ; Das, Bhudev C. ; Singh, Ishwar ; Mandal, Ashish Kumar (2007) Spindle cell carcinoma of head and neck: an immunohistochemical and molecular approach to its pathogenesis Journal of Clinical Pathology, 60 (5). pp. 472-475. ISSN 0021-9746

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Official URL: http://jcp.bmj.com/content/60/5/472.short

Related URL: http://dx.doi.org/10.1136/jcp.2005.033589


Background: Spindle cell carcinoma (SpCC) is a rare microscopic type of cancer of the mouth and oropharynx. Although SpCC is thought to arise from squamous cell carcinoma (SCC), it carries a worse prognosis. Aim: To find out the difference in immunohistochemical expression of cytokeratin, vimentin and smooth-muscle actin, and mutational alterations in the K-ras oncogene between the two tumours, in an attempt to characterise SpCC. Methods: Immunohistochemical analysis was performed by standard avidin-biotin complex method in 35 cases each of SpCCs and SCCs. DNA extracted from paraffin wax-embedded tumours was used for PCR followed by single-strand conformation polymorphism for mutational analysis of K-ras exon 1 and exon 2. Results: In the SpCC group, cytokeratin positivity was significantly higher in epithelial areas (52.2%) than in spindle cell areas (16.1%), whereas vimentin was more positive in spindle cell areas (18.7%) than epithelial areas (2.7%). Cells intermediate between epithelial and spindle cell areas were consistently positive for both cytokeratin and vimentin. Cytokeratin was found to be significantly more positive in SCC (72.6%) than the squamous component and spindle cell component of SpCC. In this study, no mutation was detected in the K-ras gene of either the SpCC or SCC group. Conclusions: The spindle cell component of SpCC is intermixed with cells that are morphologically mesenchymal but express dual antigen-positivity characteristic of epithelial (cytokeratin) and mesenchymal (vimentin) cells. These, possibly, are cells in transition suggesting that SpCC may be a sarcomatous metaplasia of SCC.

Item Type:Article
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ID Code:66958
Deposited On:28 Oct 2011 04:12
Last Modified:28 Oct 2011 04:12

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