Anthracotic and anthracosilicotic spindle cell pseudotumors of mediastinal lymph nodes: Report of five cases of a reactive lesion that simulates malignancy Journal Article


Authors: Argani, P.; Ghossein, R.; Rosai, J.
Article Title: Anthracotic and anthracosilicotic spindle cell pseudotumors of mediastinal lymph nodes: Report of five cases of a reactive lesion that simulates malignancy
Abstract: We report five cases of reactive mediastinal spindle cell proliferations associated with anthracosis and anthracosilicosis that simulated a malignant process both on clinical and morphological grounds. Clinically, the lesions formed radiographically evident masses or were infiltrative. Microscopically, a prominent storiform pattern of intertwining spindle cells was found in four cases. This proliferation extended outside of the lymph node capsule in three cases and surrounded nerves in two. Became of this combination of features, the submitted diagnoses included a malignant neoplasm in four cases. The spindle cells were immunoreactive for histiocytic markers and locally contained fine anthracotic pigment. All cases featured nodular hyaline sears and contained polarizable material suggestive of silica, although a history of industrial exposure was obtained in only two cases. No lesion has enlarged or otherwise progressed during follow-up ranging from 6 to 48 months. The differential diagnosis includes a variety of spindle cell neoplasms, including malignant fibrous histiocytoma, follicular dendritic cell tumor, spindle cell melanoma, and Kaposi's sarcoma.
Keywords: adult; clinical article; aged; middle aged; histopathology; lymph nodes; diagnosis, differential; differential diagnosis; fibrosis; immunoenzyme techniques; carcinoma; malignant neoplastic disease; spindle cell; pseudotumor; antigens, cd; actins; mediastinal neoplasms; lymphadenopathy; clinical examination; s100 proteins; mediastinum lymph node; vimentin; pneumoconiosis; histiocytoma, benign fibrous; silicosis; humans; human; male; article; anthracosis; anthracosilicosis
Journal Title: Human Pathology
Volume: 29
Issue: 8
ISSN: 0046-8177
Publisher: Elsevier Inc.  
Date Published: 1998-08-01
Start Page: 851
End Page: 855
Language: English
DOI: 10.1016/s0046-8177(98)90456-7
PUBMED: 9712428
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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  1. Ronald A Ghossein
    485 Ghossein
  2. Juan Rosai
    181 Rosai
  3. Pedram Argani
    19 Argani