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2013, Volume 29, Number 3, Page(s) 221-226     
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DOI: 10.5146/tjpath.2013.01181
Spindle Cell Rhabdomyosarcoma Displaying CD34 Positivity: A Potential Diagnostic Pitfall; Report of Two Pediatric Cases
Ayper KAÇAR1, Hacı Ahmet DEMİR2, Haydar DURAK3, Sergülen DERVİŞOĞLU3
1Department of Pathology, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, ANKARA, TURKEY
2Department of Oncology, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, ANKARA, TURKEY
3Department of Pathology, İstanbul University, Cerrahpaşa Faculty of Medicine, İSTANBUL, TURKEY
Keywords: Rhabdomyosarcoma, Antigens, CD34, Differential diagnosis

Spindle cell rhabdomyosarcoma is a rare subtype of rhabdomyosarcoma mainly seen in children. Occasional aberrant staining with a variety of immunohistochemical markers has been noted. The aberrantly expressed markers include alpha-smooth muscle actin, cytokeratin, S100, neurofilaments, CD20, immunoglobins, and CD117.

We report herein two pediatric cases displaying strong CD34 positivity and one with additional focal CD117 positivity, causing considerable difficulty in distinction from solitary fibrous tumor and extra-gastrointestinal stromal tumor.

To our knowledge, CD34 staining has been merely reported in rhabdomyosarcoma. Spindle cell rhabdomyosarcoma has to be considered in the differential diagnosis of childhood spindle cell tumors. Post-chemotherapy specimens should be evaluated in caution, since chemotherapy can cause considerable changes in tumor antigen expression. Since CD117 and CD34 are stem cell markers, their positivity in pediatric tumors should be interpreted with caution. Even if the morphology is not supportive, a wide immunohistochemical panel should be applied in childhood malignant solid tumors.

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