The histologic appearance and immunostains suggest a low grade spindle cell sarcoma with the primary considerations including a metastatic gastrointestinal stromal tumor and a low grade leiomyosarcoma. No hepatic tissue is present in the sections to confirm that the tumor is indeed within the liver.
Previous Biopsies on this Patient:
TPIS Related Resources:
National Cancer Institute PDQ treatment information on sarcoma
Liver Transplant Topics
The cytologic smears and cell block show small loose fragments of spindle and focally rounded cells with uniform oval nuclei and bipolar cytoplasm. Occasional mitoses are identified. No nerve sheath or vasogenic differentiation is seen. The tumor is negative for cytokeratin and is focally positive for smooth muscle actin with strong diffuse positivity for vimentin. This pattern of reactivity essentially excludes a carcinoma and points towards a sarcoma with attention directed to either a low grade leiomyosarcoma or a metastatic GI stromal tumor.