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<p class="ql-align-justify">Sections examine a highly cellular, high-grade malignant neoplasm composed of oval and spindle cells arranged in diffuse, solid sheets and interlacing fascicles. Cells are medium-to-large and characterized by high nuclear-to-cytoplasmic ratios, irregular nuclear contours, vesicular chromatin, and prominent nucleoli. The spindle cells feature severe nuclear pleomorphism, hyperchromasia, and bizarre multinucleated giant cells. Brisk, atypical mitotic figures are identified. Areas of necrosis are noted.</p>
<p>Pelvic mass? Vaginal? Cervical.</p>
<p class="ql-align-justify">Soft tissue piece measured 2.8x1.5x1 cm, totally embedded.</p>
<p><strong><em><u>Pelvic mass (cervical/vaginal), biopsy: </u></em></strong></p><ul><li class="ql-align-justify"><strong>High-grade malignant spindle cell neoplasm (see description and comment).</strong></li></ul><p><br></p><p><strong>Comment</strong></p><p class="ql-align-justify">This high-grade oval and spindled appearance warrants a differential diagnosis including high-grade leiomyosarcoma, undifferentiated/dedifferentiated carcinoma, sarcomatoid squamous cell carcinoma, mucosal melanoma a malignant mixed Müllerian tumor (carcinosarcoma) and GIST; to establish definitive lineage, a targeted immunohistochemical panel including <strong>Pan-CK, p40, Desmin, SMA, h-Caldesmon, CD10, Cyclin-D1, SOX10, S100, Melan-A, PAX8 & Ki-67 </strong>is required.</p>
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