Postoperative spindle cell nodules; benign non cancerous growths that can appear after surgery скачать в хорошем качестве

Postoperative spindle cell nodules; benign non cancerous growths that can appear after surgery

Postoperative spindle cell nodules (PSCNs) are benign, reactive lesions that develop after surgery or instrumentation, most often in the urinary tract (bladder, prostate) or female genital tract (cervix, uterus). They mimic malignant tumors under the microscope but are non-cancerous proliferations of myofibroblasts. 🧬 Pathogenesis Trigger: Trauma, surgery, or instrumentation (e.g., transurethral resection, biopsy). Mechanism: Reactive proliferation of myofibroblasts and fibroblasts in response to injury. Other names: Pseudosarcomatous myofibroblastic proliferation, pseudosarcomatous myofibroblastic neoplasm. 📍 Clinical Features Sites: Most common in urinary bladder and prostate. Also reported in cervix, uterus, and rarely skin. Presentation: Hematuria, urinary obstruction, or mass detected during follow-up. In gynecologic sites, may present as polypoid or nodular lesion. Timing: Usually appears weeks to months after surgery. 🔎 Diagnosis Histology: Spindle-shaped myofibroblasts arranged in fascicles. Mitotic figures may be present but atypia is minimal. Can resemble sarcoma, hence risk of misdiagnosis. Immunohistochemistry: Positive for vimentin, smooth muscle actin (SMA). Negative for markers of true sarcoma. Differential diagnosis: Sarcomas, inflammatory myofibroblastic tumor, leiomyosarcoma. ⚠️ Prognosis & Management Benign course: No malignant potential. Treatment: Simple excision or observation; recurrence is rare. Importance: Correct diagnosis avoids unnecessary radical surgery or chemotherapy #Nodules