Spindle cell lesions of the head and neck are quite diverse with great clinical and biological heterogeneity. Some lesions are malignant while many others are benign or simply reactive in nature. The spindle cells such as fibroblast, myofibroblasts, smooth muscle cells, pericytes, synovial fibroblasts and myofibroblasts are the normal constituent cell of the body. The diagnosis of tumors with spindle cell morphology is often difficult due to the variety of structures from which they can arise. These neoplasms may have unique pathologic features, wherein the spindle cell components make them the most interesting and challenging for the pathologists. Biopsies from the head and neck lesions further complicated by the range of tissues present at this site, inaccessibility and limited amount of material which may be available for study. Immunohistochemistry is a powerful and cost effective tool applicable in light microscopy. This approach along with clinical and radiographic correlation, permits more accurate classification of these lesions.
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