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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Cosmetic surgeon
Category: Dermatology
Satisfied Customers: 34991
Experience:  MBBS MS
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I received a diagnosis of CD34-Positive Spindle Cell

Resolved Question:

I received a diagnosis of CD34-Positive Spindle Cell Proliferation extending to the tissue edges with a recommendation of complete re-excision to ensure complete removal. The diagnosis was further defined as "lichen myxedematosus of plaque type". My impression from talking with my primary care physician is that re-excision is necessary as a precautionary measure and that none of these rare cells tested positive for cancer. Can you give me some straight talk about the seriousness of my diagnosis?

Thanks you
Submitted: 8 years ago.
Category: Dermatology
Expert:  Dr. Arun Phophalia replied 8 years ago.


From which area was the biopsy taken?

Dr. Arun

Customer: replied 8 years ago.
My upper right arm. The full lesion was removed.
Expert:  Dr. Arun Phophalia replied 8 years ago.


You biopsy is benign but these lesion have a tendency for the recurrence and the recurrence has an aggressive character than previous original lesion. Thus the recommendations are to remove about 2 to 5 cm of margin of the normal tissue (depending on the availability of the tissue margins) to prevent the local recurrence and to ascertain that no residual tumor has remained.

Please feel free for your follow up questions.

Dr. Arun

Dr. Arun Phophalia and other Dermatology Specialists are ready to help you
Customer: replied 8 years ago.
What is a spindle cell and does it matter that I had this on my arm for more than 20 years?
Expert:  Dr. Arun Phophalia replied 8 years ago.


A spindle cell is the name which originates from the shape of cell. It is a connective tissue cell and can undergo changes where it can multiply and give birth to a lump. This lump is benign unless there are certain changes in the cell and its nucleus, when it can undergo what we term as malignant transformation. Since the lump was there for 20 years, with the same size and shape, it is very likely that it has not gone in a change of mode i.e. malignant transformation. Sometimes they remain dormant for years together and suddenly do go in malignant change and rapidly increase in size, shape, vascularity. Why does this happens and what triggers this, is unknown. If this happens, a wide margin excision should be done to be on the safe side as any recurrence has far more aggressive nature. If there are nuclear changes in the biopsy which suggest that there was a chance of cells being going in proliferation, an excision margin of one or two inches is essential for the safety reasons.

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Dr. Arun