R. Doğan KÖSEOĞLU, Ayşe SERTÇELİK, Yaşar AYVA

A rare variant of squamous cell carcinoma of the tongue; spindle cell carcinoma

İğsi hücreli karsinoma, yassı epitel hücreli karsinomanin nadir bir alt tipidir, iğsi hücreli karsinoma çoğunlukla ağız boşluğu, dil ve üst solunum yolu mukozalarından gelişir. Dil sağ yarısında 1 yıldır devam eden şişlik şikayeti ile merkezimize başvuran 51 yaşındaki kadın hastaya yapılan insizyonel biyopsi sonucu diferansiye yassı epitel hücreli karsinoma olarak rapor edildi. Bunun üzerine hastaya sağ hemiglossektomi ve sağ boyun diseksiyonu uygulandı. Hasta yaygın metastazlar nedeni ile operasyondan 5 ay sonra öldü. Hemiglossektomi materyalinde iğsi hücrelerin meydana getirdiği yaygın tumoral infiltrasyon ve bu infiltrasyon içinde atipik görünümlü yassı epitel hücre adaları dikkati çekti. Sağ boyun diseksiyon materyalinden ayıklanan lenf nodüllerinden üçünün sinüzoidleri içinde sarkomatoid görünümde tümör hücre infiltrasyonu saptandı, immünohistokimyasal analizde hemiglossektomi materyali ve metastatik lenf nodüllerindeki bu sarkomatoid görünümdeki iğsi hücreler düşük molekül ağırlıklı sitokeratin (LMWCK) ile kuvvetli pozitif boyanma gösterdi. Hastamızın operasyon materyalindeki tumoral gelişim hem histomorfolojik hem de immünohistokimyasal bulgular temelinde yassı epitel hücreli karsinomanin bir alt tipi olan iğsi hücreli karsinoma olarak yorumlandı. Burada 51 yaşındaki kadın hastada dil sağ yarısından gelişmiş iğsi hücreli karsinomanin histomor-folojik ve immünohistokimyasal özelliklerini literatür eşliğinde sunuyoruz.

Dilde nadir görülen bir yassı hücreli karsinom varyantı: iğsi hücreli karsinom

Spindle cell carcinoma is a rare variant of squamous cell carcinoma, and is commonly seen in the mouth, tongue and upper respiratory tract. Fifty-one year old woman presented with the swelling of right half of her tongue for one year, had undergone an incisional biopsy which was reported as differentiated squamous cell carcinoma. The patient underwent right hemiglossectomy and right neck dissection, but she died of metastatic disease after 5 months. Diffuse tumoral infiltration consisting of fusiform cells was determined in the hemiglossectomy. Islands of atypical squamous epithelial cells were also noted within the diffuse tumoral infiltration areas. Sarcomatoid appearing tumoral infiltration was noted within the sinusoids of the three lymph nodes. Immunohistochemically, the hemiglossectomy material and metastatic lymph nodes showed strong positivity with LMWCK. A diagnosis of spindle cell carcinoma was made depending on both histopathological and immunohistochemical findings. In this report, we present a case of spindle cell carcinoma that is a rare variant of squamous cell carcinoma.

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