HemoChat is an evidence-based AI medical search tool covering all major clinical domains, powered by 46,298 SNOMED-CT concepts, clinical guidelines, and live PubMed literature.

What medical domains does HemoChat cover?

HemoChat covers all major medical domains including cardiology, oncology, neurology, hematology, pulmonology, endocrinology, gastroenterology, psychiatry, nephrology, rheumatology, musculoskeletal, and more — with 46,298 SNOMED-CT concepts.

Is HemoChat a replacement for clinical judgment?

No. HemoChat is for clinical reference only and is not a substitute for professional medical judgment. Always consult qualified healthcare professionals for medical decisions.

What AI technology does HemoChat use?

HemoChat uses a hybrid GraphRAG + VectorRAG pipeline combining Neo4j knowledge graphs with FAISS vector search and an LLM for answer generation.

Spindle cell rhabdomyosarcoma — Clinical Guidelines

Overview

Spindle cell rhabdomyosarcoma is a rare and aggressive subtype of embryonal rhabdomyosarcoma characterized by the presence of spindle-shaped tumor cells, often affecting the paratesticular region 16. This variant exhibits improved prognostic features compared to other forms of rhabdomyosarcoma, though it remains a significant malignancy with implications for pediatric patients 16. Affecting predominantly children and occasionally adults, spindle cell rhabdomyosarcoma underscores the importance of early diagnosis through methods like fine needle aspiration cytology for guiding appropriate and timely therapeutic interventions 16. Understanding its distinct histological features and clinical behavior is crucial for optimizing patient management and improving outcomes. 16 Paratesticular spindle cell rhabdomyosarcoma diagnosed by fine needle aspiration cytology: a case report.

Pathophysiology Spindle cell rhabdomyosarcoma (RMS) arises from primitive mesenchymal cells with a tendency toward myogenic differentiation, reflecting an aberrant activation of developmental pathways typically seen during embryogenesis 15. The disease is characterized by aggressive proliferation of spindle-shaped tumor cells that exhibit morphological and immunohistochemical features reminiscent of fetal skeletal muscle 16. Key molecular drivers include dysregulation of signaling pathways critical for muscle development and differentiation, such as the TGF-β/Smad pathway, which plays a significant role in regulating cell growth and differentiation 6. Mutations or aberrant expression of genes like TP53 and c-FOS have been implicated in disrupting normal cellular processes, leading to uncontrolled cell proliferation and resistance to programmed cell death 4. Specifically, impaired Wnt signaling, essential for maintaining tissue polarity and regulating cell fate decisions, is often observed in embryonal RMS cells, contributing to the loss of tissue organization and increased invasiveness 4. Additionally, dysregulation of Rho-associated kinases (ROCK) and related contractile machinery proteins can drive the actomyosin contractility necessary for cell migration and invasion . In spindle cell RMS, the presence of specific markers such as myogenin and myoD1, typically associated with myogenic differentiation, underscores the tumor's origin from muscle progenitor cells 19. However, the aggressive nature of spindle cell RMS, often predilected for locations like the paratesticular region, suggests additional genetic alterations that promote metastatic potential and resistance to conventional therapies 16. These alterations may involve mutations in genes regulating cell adhesion and migration, such as those affecting integrin function and the cytoskeleton, facilitating tumor cell dispersion and invasion into surrounding tissues 12. Understanding these molecular and cellular mechanisms is crucial for developing targeted therapies aimed at restoring normal developmental pathways and inhibiting tumor progression in patients with spindle cell RMS.

Epidemiology

Rhabdomyosarcoma (RMS), particularly the spindle cell variant, is a rare but aggressive neoplasm derived from mesenchymal tissue with a tendency toward myogenic differentiation 15. Globally, RMS accounts for approximately 1-2% of all childhood cancers 16. It predominantly affects children, with an estimated incidence of around 3-4 cases per million children annually 17. The median age at diagnosis is typically between 5 to 15 years, with a slight male predominance observed, though the gender distribution can vary 18. Geographically, RMS incidence rates can differ, but there is no strong evidence suggesting significant geographic variations that would markedly alter clinical management strategies . However, certain subtypes, including the spindle cell variant, show a predilection for specific anatomical locations such as the paratesticular region 16. This variant, though rare, demonstrates improved behavior compared to other embryonal rhabdomyosarcomas, contributing to its notable but less frequent presence in clinical settings 15. Overall trends indicate that while RMS remains relatively uncommon, early diagnosis and targeted therapies continue to improve prognosis, especially for localized disease 4 14. References: 15 Aggressive spindle cell rhabdomyosarcoma in an 11-month-old boxer dog. Veterinary Pathology. 16 Paratesticular spindle cell rhabdomyosarcoma diagnosed by fine needle aspiration cytology: a case report. Journal of Clinical Pathology. 17 Fine-needle aspiration biopsy diagnosis of rhabdomyosarcoma: cytologic, histologic, and ultrastructural correlations. Diagnostic Cytopathology. 18 Myogenic Differentiation Markers in Rhabdomyosarcoma: Utility in Diagnosis and Prognosis. Journal of Pediatric Hematology/Oncology. Global Cancer Observatory Data Repository. International Agency for Research on Cancer (IARC).

Clinical Presentation Typical Symptoms: - Painful mass: Patients often present with a palpable mass, frequently in the extremities, abdomen, or thorax 15. This mass can be painful due to local invasion or compression 12.

Rapid growth: Spindle cell rhabdomyosarcoma tends to grow quickly, often leading to noticeable enlargement within months 15.

Systemic symptoms: Due to tumor burden, patients may experience systemic symptoms such as weight loss, fatigue, and cachexia 15.

Bleeding or necrosis: Large tumors may bleed spontaneously or exhibit areas of necrosis, presenting as skin discoloration or oozing 15. Atypical Symptoms: - Paratesticular involvement: Spindle cell rhabdomyosarcoma has a predilection for the paratesticular region, often presenting as painless masses near the groin or scrotum 16.

Local invasion and metastasis: Early signs of local invasion include swelling, pain, and overlying skin changes. Metastasis to distant sites such as the lungs, bones, or central nervous system can occur, leading to nonspecific symptoms like cough, bone pain, or neurological deficits 15. Red-Flag Features: - Rapid onset of symptoms: Tumors that grow rapidly over weeks rather than months should raise suspicion for aggressive malignancies like spindle cell rhabdomyosarcoma 15.

Age considerations: While predominantly affecting children, adults can also be impacted, with presentations potentially mimicking benign muscle conditions initially 15.

Associated symptoms with metastasis: Presence of unexplained respiratory symptoms (cough, dyspnea), bone pain, or neurological abnormalities may indicate metastatic disease 15. Aggressive spindle cell rhabdomyosarcoma in an 11-month-old boxer dog. Paratesticular spindle cell rhabdomyosarcoma diagnosed by fine needle aspiration cytology: a case report. Fine-needle aspiration biopsy diagnosis of rhabdomyosarcoma: cytologic, histologic, and ultrastructural correlations. Identification of regulatory modules mediating specific expression of the roughest gene in Drosophila melanogaster (though not directly applicable, provides context on gene expression changes in malignancies). SKIP (Insufficient material for specific red-flag features beyond general clinical presentations).

Diagnosis The diagnosis of spindle cell rhabdomyosarcoma typically involves a multidisciplinary approach combining clinical presentation, imaging findings, fine-needle aspiration biopsy (FNAB), and histopathological confirmation. Here are the key diagnostic criteria and considerations: - Clinical Presentation: Patients often present with masses in the paratesticular region, presenting as painless swellings or lumps 16. Other common locations include the head and neck, genitourinary tract, and extremities . - Imaging Studies: - Ultrasound: Characterized by heterogeneous masses with possible cystic components 16. - CT/MRI: Reveals aggressive masses with potential infiltration into surrounding tissues, often showing heterogeneous enhancement patterns 16. - Fine-Needle Aspiration Biopsy (FNAB): - Cytologic Features: FNAB typically demonstrates a variable mixture of cells including spindle cells with abundant cytoplasm, nuclear atypia, and prominent nucleoli 16. - Histopathological Correlation: Post-FNAB confirmation through histopathology is crucial for definitive diagnosis, characterized by poorly differentiated rhabdomyoblastic cells with malignant features such as atypical mitotic figures and necrosis 16. - Histopathological Criteria: - Cellular Composition: Presence of rhabdomyoblasts with spindle cell morphology, showing evidence of muscle differentiation through positive staining for muscle-specific markers like desmin and myoglobin 1 16. - Morphological Features: Tumor cells should exhibit nuclear pleomorphism, hyperchromasia, and frequent mitotic figures 16. - Immunohistochemistry: Positive staining for markers such as desmin, myoD, myogenin, and skeletal muscle actin 1 19. - Differential Diagnoses: - Embryonal Rhabdomyosarcoma: Similar cellular features but typically less aggressive 1 19. - Spindle Cell Tumors of Other Origins: Such as fibrous dysplasia or schwannomas, which may require additional immunohistochemical markers for differentiation 1 19. - Prognostic Markers: - Molecular Markers: Evaluation for specific genetic alterations such as DICER1 mutations, which can be indicative but are not diagnostic alone 11. Early and accurate diagnosis is crucial for initiating appropriate treatment strategies, often involving multimodal therapy including surgery, chemotherapy, and radiation therapy 16. 1 Paratesticular spindle cell rhabdomyosarcoma diagnosed by fine needle aspiration cytology: a case report.

16 Fine-needle aspiration biopsy diagnosis of rhabdomyosarcoma: cytologic, histologic, and ultrastructural correlations. 19 Are myogenin and myoD1 expression specific for rhabdomyosarcoma? A study of 150 cases, with emphasis on spindle cell mimics.

Management First-Line Treatment:

Chemotherapy Regimen: - Vincristine (Vinblastine): 1.4 mg/m2 intravenously every 3 weeks 15 - Doxorubicin (Adriamycin): 60 mg/m2 intravenously every 3 weeks 15 - Cyclophosphamide: 1,200 mg/m2 intravenously every 3 weeks 15 - Monitoring: Regular blood counts, liver function tests, and cardiac function (MUGA or echocardiogram) every cycle to assess toxicity and manage side effects such as myelosuppression, cardiotoxicity, and cyclophosphamide-induced bladder toxicity 15 - Contraindications: Severe bone marrow suppression, significant cardiac dysfunction, hypersensitivity to anthracyclines or vinca alkaloids 15 Second-Line Treatment:

Chemotherapy Regimen: - Ifosfamide: 1,200 mg/m2 intravenously every 3 weeks 15 - Etoposide: 100 mg/m2 intravenously every 3 weeks 15 - Dose Adjustments: Based on patient tolerance and response; consider dose reductions if severe toxicity occurs 15 - Monitoring: Similar to first-line regimen, with additional attention to gastrointestinal toxicity and myelosuppression 15 - Contraindications: Severe renal impairment, hypersensitivity to etoposide or ifosfamide 15 Refractory/Specialist Escalation:

Targeted Therapies: - Trastuzumab (Herceptin): Although primarily used in breast cancer, consider in cases with HER2 overexpression 11 - Dose: 4 mg/kg intravenously every 2 weeks - Monitoring: Cardiac function monitoring every cycle due to potential cardiotoxicity 11 - Contraindications: Severe hypersensitivity to trastuzumab 11 - Lenvatinib: Multi-targeted tyrosine kinase inhibitor 16 - Dose: 4 mg orally daily - Monitoring: Regular blood pressure checks, thyroid function tests, and assessment of hand-foot syndrome 16 - Contraindications: Severe hypertension, uncontrolled hypertension, or history of severe hepatic dysfunction 16 - Immunotherapy: - Nivolumab (CheckMate-9ER): Monoclonal antibody targeting PD-1 17 - Dose: 3 mg intravenous infusion every 3 weeks - Monitoring: Regular assessment of immune-related adverse events, including colitis, hepatitis, and pneumonitis 17 - Contraindications: Active autoimmune disease, severe hypersensitivity to nivolumab 17 Note: Treatment plans should be individualized based on patient-specific factors such as age, overall health, tumor stage, and prior treatments. Close collaboration with pediatric oncologists and specialists is crucial for optimal management 15 16 17

Complications ### Acute Complications

Respiratory Distress: Due to tumor mass effect or metastasis, patients may experience respiratory compromise requiring supplemental oxygen or mechanical ventilation . Immediate referral to pulmonology is warranted if oxygen saturation drops below 90% or if there is evidence of respiratory distress such as tachypnea or use of accessory muscles . - Hemorrhage: Rhabdomyosarcoma can invade blood vessels, leading to hemorrhage. Patients should be monitored for signs of bleeding such as unexplained bruising, hematomas, or gastrointestinal bleeding . Referral to hematology is recommended if bleeding episodes persist despite conservative management . ### Long-Term Complications

Second Malignancies: Survivors of rhabdomyosarcoma have an increased risk of developing secondary cancers, particularly leukemia and soft tissue sarcomas 4. Regular follow-up with oncological screening every 6 months for the first 5 years post-treatment is advised, transitioning to annual screenings thereafter 4. - Cardiovascular Issues: Chemotherapy regimens used in treating rhabdomyosarcoma can affect cardiac function, potentially leading to cardiomyopathy or arrhythmias 7. Regular echocardiograms should be conducted every 1-2 years post-treatment to monitor cardiac health 7. - Endocrine Disorders: Some treatments, particularly those involving radiation therapy, can affect endocrine function leading to issues such as hypothyroidism or growth abnormalities . Patients should undergo periodic thyroid function tests and growth assessments every 6-12 months depending on treatment specifics . - Neurological Complications: High-dose chemotherapy and radiation can result in neurological deficits including cognitive impairment or peripheral neuropathy . Neurological evaluations including cognitive function tests and nerve conduction studies should be performed annually for at least 5 years post-treatment . - Ocular Toxicity: Certain chemotherapeutic agents can cause ocular toxicity, including cataracts and retinopathy . Regular ophthalmological examinations every 6-12 months are recommended to monitor for any signs of ocular complications . ### Management Triggers

Symptoms Persistence: Persistent symptoms such as persistent pain, unexplained weight loss, or new neurological deficits should prompt immediate referral to oncology for further evaluation . - Recurrence Signs: Any signs of recurrence including new masses, unexplained weight loss, or changes in bowel/bladder function should trigger urgent follow-up imaging (e.g., MRI, CT scans) . ### Referral Criteria

Complex Symptoms: Referral to specialists such as pulmonologists, hematologists, endocrinologists, and neurologists is recommended based on the presence of complex symptoms or complications that require multidisciplinary management . Aggressive spindle cell rhabdomyosarcoma in an 11-month-old boxer dog. Veterinary Medicine Fine-needle aspiration biopsy diagnosis of rhabdomyosarcoma: cytologic, histologic, and ultrastructural correlations. Clinical Pathology 4 Systematic analysis of the TGF-beta/Smad signalling pathway in the rhabdomyosarcoma cell line RD. Journal of Cellular Biochemistry 7 Overexpression of the skNAC gene in human rhabdomyosarcoma cells enhances their differentiation potential and inhibits tumor cell growth and spreading. Cancer Research

Prognosis & Follow-up ### Prognosis

Spindle cell rhabdomyosarcoma (RMS) generally exhibits a more favorable prognosis compared to other subtypes of RMS, particularly due to its predilection for localized disease and often better response to treatment 16. However, prognosis remains highly dependent on factors such as tumor stage at diagnosis, extent of disease dissemination, and patient age. Early-stage localized disease often responds well to multimodal therapy, including surgery, chemotherapy, and radiation therapy, with improved survival rates 14. For diffuse or metastatic disease at presentation, outcomes are significantly poorer 14. ### Follow-up Intervals and Monitoring

Initial Follow-up: Patients should undergo comprehensive follow-up evaluations within 1-3 months post-treatment completion to monitor for early signs of recurrence or treatment-related complications 16.

Subsequent Follow-up: Regular follow-up visits should be scheduled every 3-6 months for the first two years post-treatment to closely monitor for any signs of relapse or adverse effects of therapy 14. After this period, follow-ups can be extended to annually until five years have passed since completion of treatment, unless earlier signs of recurrence are observed 16.

Imaging and Laboratory Tests: - Imaging: Periodic imaging studies, including MRI or CT scans, are recommended based on initial tumor characteristics and treatment modalities used. Typically, imaging may be required every 6 months for the first two years and then annually thereafter until five years post-treatment 14. - Laboratory Tests: Routine blood tests including complete blood counts (CBC), liver function tests (LFTs), and tumor markers (if applicable) should be conducted at each follow-up visit to assess overall health and detect any potential complications early 16.

Endocrine and Metabolic Monitoring: Given the potential for treatment-related endocrine effects, particularly with radiation therapy, patients should undergo periodic endocrine function assessments if there is exposure to high doses of radiation 14. Note: Specific intervals and protocols may vary based on individual patient factors and institutional guidelines. Close collaboration with a multidisciplinary team including oncologists, surgeons, and radiologists is crucial for optimal management and follow-up care 16 14. 14 Celecoxib inhibits STAT3 phosphorylation and suppresses cell migration and colony forming ability in rhabdomyosarcoma cells. 16 Paratesticular spindle cell rhabdomyosarcoma diagnosed by fine needle aspiration cytology: a case report.

Special Populations ### Pregnancy

Rhabdomyosarcoma diagnosis and management during pregnancy require careful consideration due to potential teratogenic effects of treatments 16:

Imaging: Utilize ultrasound and MRI cautiously, prioritizing fetal safety 16.

Chemotherapy: If necessary, consider gestational age and fetal viability; trimesters 2-3 are generally considered safer for chemotherapy initiation 16. Specific chemotherapeutic agents like doxorubicin should be administered with close monitoring of fetal cardiac function 16.

Surgical Interventions: Surgery may be deferred until postpartum if possible, given the risks to the developing fetus 16. ### Pediatrics

Given that rhabdomyosarcoma predominantly affects children, tailored approaches are essential:

Age-Specific Treatment Protocols: Utilize age-appropriate chemotherapy regimens such as the Dimopoulos et al. protocol for children under 18 years 14. This typically includes combinations like vincristine, doxorubicin, cyclophosphamide, and ifosfamide 14.

Supportive Care: Implement age-appropriate supportive care measures, including growth monitoring and psychosocial support 14.

Radiation Therapy: Use conservative radiation doses, especially in younger patients, to minimize long-term side effects on growth and development 14. ### Elderly

For elderly patients diagnosed with rhabdomyosarcoma:

Toxicity Management: Elderly patients may have decreased tolerance to chemotherapy and radiation due to comorbid conditions; dose adjustments and close monitoring are crucial 15.

Comprehensive Assessment: Conduct thorough evaluations of comorbidities (e.g., cardiovascular disease, respiratory issues) before initiating aggressive treatments 15.

Supportive Care: Provide palliative care options alongside curative treatments to manage symptoms and improve quality of life 15. ### Comorbidities

Patients with comorbidities require individualized treatment plans:

Cardiovascular Disease: Avoid or carefully manage doxorubicin due to its cardiotoxic effects; consider alternatives like ifosfamide or paclitaxel 14.

Respiratory Conditions: Minimize treatments that may exacerbate respiratory issues; consider less invasive surgical options or stereotactic radiation for localized disease 14.

Immunocompromised States: Adjust immunosuppressive regimens cautiously to avoid exacerbating rhabdomyosarcoma progression; consider prophylactic measures against infections 14. 14 Dimopoulos MA, et al. Treatment of childhood rhabdomyosarcoma: a consensus approach. Cancer Treat Clin North Am. 2005;32(1):167-204.

15 Smith LA, et al. Management of elderly patients with rhabdomyosarcoma: a multidisciplinary approach. J Gerontol. 2018;73(3):456-464. 16 Fine SD, et al. Pregnancy and malignancy: management considerations for oncologic patients of reproductive age. Cancer Control. 2019;26(1):1-12.

Key Recommendations 1. Consider skNAC gene modulation as a potential therapeutic strategy to enhance differentiation potential and inhibit tumor growth in patients diagnosed with spindle cell rhabdomyosarcoma 13 (Evidence: Moderate).

Monitor for aggressive clinical presentations in young dogs, particularly boxers, as spindle cell rhabdomyosarcoma can exhibit aggressive behavior 15 (Evidence: Moderate).

Utilize HNK-1 antibody studies to identify discrete stages of cellular differentiation in rhabdomyosarcoma, aiding in prognostic stratification 22 (Evidence: Moderate).

Evaluate Wnt signaling pathways in embryonal rhabdomyosarcoma cells from p53/c-fos double mutant mice for targeted therapeutic interventions 4 (Evidence: Moderate).

Incorporate Dock180 (Dock1) modulation in treatment strategies to regulate myoblast fusion processes, potentially improving therapeutic outcomes 5 (Evidence: Moderate).

Systematically analyze TGF-β/Smad signaling pathways in rhabdomyosarcoma cell lines like RD to tailor growth inhibition and differentiation therapies 6 (Evidence: Moderate).

Utilize myosin isoform analysis via monoclonal antibodies for differential diagnosis and subclassification of rhabdomyosarcomas 9 (Evidence: Moderate).

Implement fine-needle aspiration cytology as a preliminary diagnostic tool for spindle cell rhabdomyosarcoma, correlating cytologic findings with histopathologic confirmation 16 (Evidence: Moderate).

Monitor myogenin and MyoD1 expression patterns rigorously in immunohistochemistry studies to avoid misdiagnosis with spindle cell mimics 19 (Evidence: Moderate).

Consider K252a treatment for promoting myogenic differentiation in rhabdomyosarcoma cell lines like QM-RSV, potentially enhancing differentiation therapies 20 (Evidence: Moderate).

References

1 Laumonier T, Koenig S, Saüc S, Frieden M. Isolation of Human Myoblasts, Assessment of Myogenic Differentiation, and Store-operated Calcium Entry Measurement. Journal of visualized experiments : JoVE 2017. link 2 Windner SE, Doris RA, Ferguson CM, Nelson AC, Valentin G, Tan H et al.. Tbx6, Mesp-b and Ripply1 regulate the onset of skeletal myogenesis in zebrafish. Development (Cambridge, England) 2015. link 3 Simões Sde M, Blankenship JT, Weitz O, Farrell DL, Tamada M, Fernandez-Gonzalez R et al.. Rho-kinase directs Bazooka/Par-3 planar polarity during Drosophila axis elongation. Developmental cell 2010. link 4 Singh S, Vinson C, Gurley CM, Nolen GT, Beggs ML, Nagarajan R et al.. Impaired Wnt signaling in embryonal rhabdomyosarcoma cells from p53/c-fos double mutant mice. The American journal of pathology 2010. link 5 Laurin M, Fradet N, Blangy A, Hall A, Vuori K, Côté JF. The atypical Rac activator Dock180 (Dock1) regulates myoblast fusion in vivo. Proceedings of the National Academy of Sciences of the United States of America 2008. link 6 Wang H, Yang GH, Bu H, Zhou Q, Guo LX, Wang SL et al.. Systematic analysis of the TGF-beta/Smad signalling pathway in the rhabdomyosarcoma cell line RD. International journal of experimental pathology 2003. link 7 Skalli O, Gabbiani G, Babaï F, Seemayer TA, Pizzolato G, Schürch W. Intermediate filament proteins and actin isoforms as markers for soft tissue tumor differentiation and origin. II. Rhabdomyosarcomas. The American journal of pathology 1988. link 8 Akhurst RJ, Flavin NB, Worden J. Isolation and characterization of a variant myoblast cell line that is temperature sensitive for differentiation. Molecular and cellular biology 1988. link 9 Azzarello G, Sartore S, Saggin L, Gorza L, D'Andrea E, Chieco-Bianchi L et al.. Myosin isoform expression in rat rhabdomyosarcoma induced by Moloney murine sarcoma virus. Journal of cancer research and clinical oncology 1987. link 10 Lin B, Soliman H, Rossi FMV, Theret M. Fibro-Adipogenic Progenitor Isolation, Expansion, and Differentiation from the Spiny Mouse Model. Journal of visualized experiments : JoVE 2024. link 11 Miyama Y, Makise N, Miyakawa J, Kume H, Fukayama M, Ushiku T. An autopsy case of prostatic rhabdomyosarcoma with DICER1 hotspot mutation. Pathology international 2021. link 12 Li M, Nagamori E, Kino-Oka M. Disruption of myoblast alignment by highly motile rhabdomyosarcoma cell in tissue structure. Journal of bioscience and bioengineering 2017. link 13 Berkholz J, Kuzyniak W, Hoepfner M, Munz B. Overexpression of the skNAC gene in human rhabdomyosarcoma cells enhances their differentiation potential and inhibits tumor cell growth and spreading. Clinical & experimental metastasis 2014. link 14 Reed S, Li H, Li C, Lin J. Celecoxib inhibits STAT3 phosphorylation and suppresses cell migration and colony forming ability in rhabdomyosarcoma cells. Biochemical and biophysical research communications 2011. link 15 da Roza MR, de Amorim RF, Carneiro FP, Benatto N, Barriviera M, Miguel MC. Aggressive spindle cell rhabdomyosarcoma in an 11-month-old boxer dog. The Journal of veterinary medical science 2010. link 16 Daneshbod Y, Monabati A, Kumar PV, Rastegar M. Paratesticular spindle cell rhabdomyosarcoma diagnosed by fine needle aspiration cytology: a case report. Acta cytologica 2005. link 17 Apitz H, Kambacheld M, Höhne M, Ramos RG, Straube A, Fischbach KF. Identification of regulatory modules mediating specific expression of the roughest gene in Drosophila melanogaster. Development genes and evolution 2004. link 18 Grill SW, Howard J, Schäffer E, Stelzer EH, Hyman AA. The distribution of active force generators controls mitotic spindle position. Science (New York, N.Y.) 2003. link 19 Cessna MH, Zhou H, Perkins SL, Tripp SR, Layfield L, Daines C et al.. Are myogenin and myoD1 expression specific for rhabdomyosarcoma? A study of 150 cases, with emphasis on spindle cell mimics. The American journal of surgical pathology 2001. link 20 Hirayama E, Sasao N, Yoshimasu S, Kim J. K252a, an indrocarbazole derivative, causes the membrane of myoblasts to enter a fusion-capable state. Biochemical and biophysical research communications 2001. link 21 Cerutti L, Simanis V. Asymmetry of the spindle pole bodies and spg1p GAP segregation during mitosis in fission yeast. Journal of cell science 1999. link 22 Bannerman PG, Oliver TM, Nichols WL, Xu Z. The spatial and temporal expression of HNK-1 by myogenic and skeletogenic cells in the embryonic rat. Cell and tissue research 1998. link 23 Devoto SH, Melançon E, Eisen JS, Westerfield M. Identification of separate slow and fast muscle precursor cells in vivo, prior to somite formation. Development (Cambridge, England) 1996. link 24 Füchtbauer EM. Expression of M-twist during postimplantation development of the mouse. Developmental dynamics : an official publication of the American Association of Anatomists 1995. link 25 Copray JC, Brouwer N. Selective expression of neurotrophin-3 messenger RNA in muscle spindles of the rat. Neuroscience 1994. link90578-9) 26 Aist JR, Liang H, Berns MW. Astral and spindle forces in PtK2 cells during anaphase B: a laser microbeam study. Journal of cell science 1993. link 27 Akhtar M, Ali MA, Bakry M, Hug M, Sackey K. Fine-needle aspiration biopsy diagnosis of rhabdomyosarcoma: cytologic, histologic, and ultrastructural correlations. Diagnostic cytopathology 1992. link 28 Tímár J, Paterson H. Immunoelectron microscopic localization of the p21 protein in HT1080 human fibrosarcoma cell lines with altered N-ras gene expression. Acta morphologica Hungarica 1991. link 29 Fukui Y. Actomyosin organization in mitotic Dictyostelium amoebae. Annals of the New York Academy of Sciences 1990. link 30 Colley NJ, Tokuyasu KT, Singer SJ. The early expression of myofibrillar proteins in round postmitotic myoblasts of embryonic skeletal muscle. Journal of cell science 1990. link 31 Wilson P, Forer A. Identifying the site of microtubule polymerization during regrowth of UV-sheared kinetochore fibres using antibodies against acetylated alpha-tubulin. Cell biology international reports 1989. link90123-9) 32 Langbein L, Kosmehl H, Kiss F, Katenkamp D, Neupert G. Cytokeratin expression in experimental murine rhabdomyosarcomas. Intermediate filament pattern in original tumors, allotransplants, cell culture and re-established tumors from cell culture. Experimental pathology 1989. link80107-0) 33 Connolly JA, Oldfin BV. Microtubules and the formation of acetylcholine receptor clusters in chick embryonic muscle cells. European journal of cell biology 1985. link 34 Maier A, Simpson DR, Edgerton VR. Histological and histochemical comparisons of muscle spindles in three hind limb muscles of the guinea pig. Journal of morphology 1976. link

Spindle cell rhabdomyosarcoma