Cutaneous spindle cell neoplasms: Pattern-based diagnostic approach

Author(s): Choi JH, Ro JY



Spindle cell neoplasms arising in the skin comprise a heterogeneous group of tumors with divergent lineages. Cutaneous spindle cell neoplasms are relatively common and present surgical pathologists with diagnostic challenges. Recognition of their histopathologies is important for correct diagnosis and management. The current review presents a pattern-based diagnostic approach to common cutaneous spindle cell neoplasms that often cause diagnostic difficulties.


To provide a useful guide for diagnosis of cutaneous spindle cell neoplasms.

Data Sources.—

PubMed (US National Library of Medicine) reports and the authors' personal experiences are reviewed.


The authors briefly summarize the histologic features and differential diagnoses of common cutaneous spindle cell neoplasms.

Cutaneous neoplasms entirely or predominantly composed of spindle cells constitute a heterogeneous group of mesenchymal and nonmesenchymal tumors. Cutaneous spindle cell neoplasms are often diagnostically challenging because of considerable morphologic overlap among the various tumor types that compose this group. Furthermore, they are often difficult to diagnose accurately, especially when only partial or superficial samples are available. However, a pattern-based diagnostic approach can help pathologists arrive at a specific diagnosis or differential diagnoses of tumors and tumorlike lesions. Here, we review the histologic features and differential diagnoses of common cutaneous spindle cell neoplasms, based on their architectural (growth) patterns.

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