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Sarcomatoid thymic carcinoma
Haematoxylin & Eosin (H&E)
74 years
74 years old man with mediastinal tumor.
Tumor with storiform and fascicular spindle cell growth pattern, resembling sarcoma. Immunohistochemical positivity for Vimetin and focal positivitiy for pan-cytokeratin 22.
There must be an epithelial differentiation (sometimes only focal), positive for cytokeratin on immunhistochemistry. Sometimes there may be components of rhabdo- or osteosarcoma. The distinction from rhabdomyosarcoma is important (children or young patients, expression of cytokeratins together with muscular markers in the same tumor cells). Other differential diagnoses are type A- thymoma (spindle cells with real epithelial differentiation), spindel cell carcinoid (positive for neuroendocrine markers), metaplastic thymoma (bland looking cytology and low proliferation fraction) and synovial sarcoma (FISH for proving the SYT-Rearrangement).
Huber Bettina
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