IMMUNOHISTOCHEMICAL MARKERS FOR THE DIAGNOSIS OF ORAL SPINDLE CELL LESIONS: A REVIEW

Abstract

<h3>Objectives</h3> To review the useful immunohistochemical markers in the diagnosis of spindle cell lesions of the oral cavity. <h3>Study Design</h3> A narrative review of the literature was carried out in PubMed and Portal Periódicos CAPES databases. Immunohistochemical profiles of myofibroblastic (myofibroma, inflammatory myofibroblastic tumor, low-grade myofibroblastic sarcoma), fibroblastic (solitary fibrous tumor, fibromatosis, nodular fasciitis, fibrosarcoma), and muscular (leiomyoma, angioleiomyoma, leiomyosarcoma) lesions was collected. <h3>Results</h3> A graphic summary of the results was elaborated. Of notice, h-caldesmon and smooth muscle myosin are helpful to differentiate myofibroblastic and muscular lesions. CD34, bcl-2, and CD99 are useful for diagnosing solitary fibrous tumor. The lack of desmin expression in myofibroma may help in the differentiation from leiomyoma. p53 and Ki-67 may help in the diagnosis of malignant lesions. <h3>Conclusions</h3> Immunohistochemistry is often useful to stablish the histopathologic diagnosis of oral spindle cell lesions of myofibroblastic, fibroblastic, and muscular origin, though a large panel can be necessary. H-caldesmon, smooth muscle actin, smooth muscle myosin, desmin, and muscle-specific actin are of great importance. Other markers such as CD99 and ALK-1 are useful for specific lesions.