POSTRADIATION PRIMARY INTRANODAL LEIOMYOSARCOMA

An unusual case of post-radiation primary intranodal leiomyosarcoma of the cervical lymph node is presented. The patient was a 32-year-old w hite man who was treated in 1986 with hemiglossectomy and right neck d issection, followed by radiation therapy, for squamous cell carcinoma of the tongue. Six years later, he presented with an enlarged left cer vical lymph node which on biopsy showed a high grade spindle cell mali gnant neoplasm. Immunohistochemistry and election microscopic study ve rified the smooth muscle origin of the tumour. Extensive work-up for a second primary lesion was negative. Primary intranodal leiomyosarcoma is extremely rare. We briefly discuss the histological differential d iagnosis of spindle cell lesions of lymph nodes, leiomyosarcoma of the vessel wall and radiation-associated sarcoma.