Hyalinising spindle cell tumour with giant rosettes: report of a case with unusual features including original histological and ultrastructural observations

• Published in: Pathology Vol. 33; no. 1; pp. 101 - 107
• Main Authors: Scolyer, Richard A., Mccarthy, Stanley W., Wills, Edward J., Palmer, Allan A.
• Format: Journal Article
• Language: English
• Published: London Elsevier B.V 01.02.2001; Informa UK Ltd; Taylor and Francis
• Subjects: Aged; Biological and medical sciences; Biomarkers, Tumor - analysis; Collagen - ultrastructure; Dermatology; Female; Fibroblasts - ultrastructure; fibromyxoid sarcoma; fibrosarcoma; Fibrosarcoma - chemistry; Fibrosarcoma - pathology; Fibrosarcoma - surgery; Humans; Hyalin - ultrastructure; hyalinising spindle cell tumour with giant rosettes; Immunoenzyme Techniques; low-grade fibrosarcoma with palisaded granulomalike bodies; Medical sciences; Neoplasm Proteins - analysis; pathology; rosette; Soft tissue; Soft Tissue Neoplasms - chemistry; Soft Tissue Neoplasms - pathology; Soft Tissue Neoplasms - surgery; Stromal Cells - ultrastructure; T-Lymphocytes - pathology; Treatment Outcome; Tumors of the skin and soft tissue. Premalignant lesions; low-grade fibrosarcoma with palisaded granulomalike bodies; rosette; pathology; hyalinising spindle cell tumour with giant rosettes; fibromyxoid sarcoma; Soft tissue; fibrosarcoma; Human; Immunohistochemistry; Sarcoma; Fusiform cell; Fibrosarcoma; Malignant tumor; Hyaline substance; Electron microscopy; Case study; Pathology; Low malignancy; Female; Elderly
• ISSN: 0031-3025; 1465-3931
• DOI: 10.1080/00313020120034984

Hyalinising spindle cell tumour with giant rosettes (HSCTGR) is an uncommon, recently described low-grade sarcoma which shares many histological features with low-grade fibromyxoid sarcoma (LGFMS). We report a case of HSCTGR occurring in the deep soft tissues of the thigh of a 46-year-old woman, that presented as a slowly growing, painless mass. Microscopically the tumour was composed of spindled stromal cells amongst which were scattered so-called collagen rosettes. The distinctive feature of this case was the previously unreported finding of lymphoid cells of T-cell phenotype admixed with fibrohistioctyic cells in the cellular cuff surrounding the collagenous core of the rosettes. The case was further unusual in that it included focal areas of increased cellularity with a mitotic count of up to three per 10 high-power fields. While the latter feature has been associated with increased recurrences and metastases in LGFMS, it is not known whether the significance is similar in HSCTGR. The spindled stromal cells showed ultrastructural features of poorly differentiated fibroblasts, while those at the edges of the rosettes showed features of altered fibroblasts, some with a fibrohistiocytic appearance. These findings support the interpretation that HSCTGR forms part of the spectrum of sarcomas showing fibroblastic differentiation.