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

Pedram Argani, Ronald Ghossein, Juan Rosai

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)851-855
Number of pages5
JournalHuman pathology
Volume29
Issue number8
DOIs
StatePublished - Jan 1 1998

Keywords

  • Anthracosis
  • Pseudotumor
  • Silicosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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