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Several cases have been accompanied by squamous metaplasia or spindle cell differentiation [ 3- 5].
Another two cases were characterized by a lobular growth pattern and one case by pure spindle cell differentiation.
The histological record yielded spindle cell differentiation with whorl-like or palisading patterns in 67 GISTs (64%).
In this study, squamous metaplasia was present in four cases, spindle cell differentiation in one, and cartilaginous metaplasia in one (had not been published in the literature).
Focal metaplasia was present in six cases (8.2%), including squamous metaplasia in four, spindle cell differentiation in one, and cartilaginous metaplasia in one.
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Histopathological examination identified the tumor as an anaplastic carcinoma of the pancreas, composed of a ductal carcinoma component, along with bizarre giant cells and spindle-cell differentiation (Fig. 5a).
Five of these were biphasic with a combination of tubular structures and multilayered myoepithelial elements, whereas three showed additional areas of pure spindle-cell differentiation with bland cytomorphology.
Identification of areas of squamous differentiation in spindle cell carcinomas and the presence of spindle cells in carcinomas with squamous metaplasia are not infrequent.
It is a benign tumor that has recently been defined as a multinodular myxoid tumor involving the gastric antrum with a peculiar plexiform growth pattern, myxoid stroma, prominent vasculature, and spindle cells with myofibroblastic differentiation [6, 7].
Spindle cells exhibited myofibroblastic differentiation with peripheral cytoplasmic thin filaments and interspersed focal densities (Fig. 4B).
Interestingly, one of these 11 cases was a spindle cell metaplastic carcinoma with focal squamous differentiation.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com