Flashcards in Soft tissue tumors Deck (65):
____ is a benign tumor of adipose tissue.
What is needed to really the difference between lipoma and liposarcoma?
What is the characteristic cell of liposarcoma?
lipoblast- bizarre nucleus and vesicles of lipid in cytoplasm
____ is the most common benign soft tissue tumor in adults.
_____ is the most common malignant soft tissue tumor in adults.
What are the 2 types of reactive proliferations
nodular fasciitis and myositis ossificans
____ is a rapidly growing, small benign fibrous proliferation on the subcutis, usually encountered as a small mass.
Who is nodular fasciitis most prevalent in? What is characteristic about the history?
Young adults-- rapid growth
Where does nodular fasciitis commonly appear?
arms, esp flexor aspects of forearms, subdermal fat
Where and when does mysotitis ossificans occur?
lower limb, blunt trauma
_____ is reactive bone formation in muscle as a result of injury.
What is seen with mysositis ossificans histologically? How is it differentiated from malignancy?
woven bone in granulation tissue. Bone will be well formed at periphery but immature at center. Malignancy will lack this maturation
What is encompassed in superficial fibromatoses?
small lesions of the hand (palmar, Dupuytren contraction, knuckle pads, infantile digital fibromatoses)
Penis (penile/ Peyronie)
What is the most common superficial fibromatoses?
Age group, uni or bilateral, and sex of palmar fibromatoses
increases over 40, men (until over 80), frequently bilateral
Age group, and uni or bilateral of plantar fibromatosis
younger age group, bilateral
What characterizes infantile digital fibromatosis?
peculiar inclusion like condensations of cytoplasmic actin
Penile fibromatoses are often associated with what?
other superifcial fibromatoses
What fingers are most commonly afftected by Dupuytrens?
ring and pinky
T of F Dupuytrens progresses slowly and is usually painless.
What happens to the palmar aponeurosis in Dupuytrens contracture
becomes hyperplastic and undergoes contracture
What is encompassed in deep fibromatosis?
aggressive fibromatosis, musculoaponeurotic fibromatosis, desmoid tumors
Describe the deep fibromatosis seen in the pediatric population.
female, most are extra-abdominal
Describe the deep fibromatosis in pt in late 20s.
female, most are of abdominal wall
Describe deep fibromatosis of later adult years
no sex presdis., fewer abdominal tumors
T of F Deep fibromatosis tumors are large and local control can prove difficult, but despite their capacity for local aggression, deep fibromatosis do not metastasize.
What is seen with deep fibromatosis histologically?
bland fibroblast prolif, NOT monoclonal
____ is a tumor of mesenchymal cell origin that is composed of malignant fibroblasts in a collagen background
Where does fibrosacroma of bone usually happen?
metaphysis of long bones in lower extremities like femur and tibia and pelvis.
Age and sex of fibrosarcoma of bone
men, 4th decade painful
Where and when do fibrosarcoma on soft tissue occur
wider age spectrum 35-55; thigh and posterior knee with ill defined margins, painless
Describe the infantile form of fibrosarcoma
Appearance of fibrosarcoma histologically
herringbone pattern, nuclei have spindle shaped nucleus
____ is a noncancerous growth of dermal dendritic histiocytic cells.
Dermatofibromas can arise at the site of ____
injury like inject bite or thorn prick. most often legs and arms.
What do the dermatofibromas look like?
firm nodules that are often yellow-brown, sometimes pink, sometimes dark. A dimple forms if squeezed indicating tethering
histo: bland histocyte type cells interdigitate between normal collagen bundles
What is dermatofibrosarcoma protuberans?
relatively uncommon soft tissue neoplasm with intermediate- to low-grade malignancy. Although metastasis rarely occurs, DFSP is a locally aggressive tumor with a high recurrence rate; it is a cutaneous malignancy that arises from the dermis and invades deeper subcutaneous tissue
What is the cellular origin of dermatofibrosarcoma protuberans
The cellular origin of DFSP is not clear. Evidence exists that supports the cellular origin being fibroblastic, histiocytic, or neuroectodermal. DFSP manifests partial features of each. Therefore, many authorities suggest pluripotential progenitor cells, such as undifferentiated mesenchymal cells, may be the origin of DFSP, because DFSP has a capacity to differentiate into all 3 cell types.
What does dermatofibrosarcoma tumor look like (grossly and histo)
Grossly: umbilicated, somewhat irregular neoplasm; Histo: greater cellularity than dermatofibroma with greater cellular atypia, though without mitotic figures or necrosis
_____ is the most common soft-tissue sarcoma occurring in late adult life.
malignant fibrous histiocytoma
____ tumor contains both fibroblastlike and histiocytelike cells in varying proportions, with spindled and rounded cells exhibiting a storiform (Latin, storea, “woven mat”) arrangement
malignant fibrous histiocytoma
What is the most important prognostic factor with malignant fibrous histiocytoma
The clinical stage of the tumor, which is defined by tumor grade, size, and presence of distant metastases
What is the most common location of metastasis for malignant fibrous histiocytoma?
lung (90%), bone (8%), and liver (1%).
The rate of metastasis for MFH varies with what?
the histologic subtype from 23% (myxoid) to 50% (giant cell).
What is associated with decreased incidence of local recurrence of MFH?
resection with negative microscopic margins decreases
T or F Retroperitoneal MFH have better prognosis.
Histological appearance MFH
Storiform, or can be typical bizarre giant cells
What is involved in the transition from benign to malignant FH?
Dermatofibroma to dermatofibrosarcoma protuberans to malignant fibrous histiocytoma
*increased cellularity, storiform
____ have a white fish flesh appearance
Rhabdomyosarcoma is a tumor made up of cancerous muscle cells called _____.
Age group associated with RMS
less then 15, 2/3 are younger than 10
RMS may arise in any muscle in the body, but the most common sites for this tumor are:
Adjacent to the base of the skull (parameningeal)
Around the eye (orbital)
Other sites in the head and neck, such as the nose and throat (nasopharngeal)
Arms and legs (extremities)
Urinary system and reproductive sexual organs (GU, or genitourinary: includes bladder, vagina, prostate and paratesticular sites
Histo appearance of RMS
bizarre cells; elongated “strap” cells may recapitulate skeletal muscle cells. Some may even have cross striations like muscle or bizarre cells with abundant pink cytoplasm.
______is the most common place to find leiomyomas.
Why might there be necrosis and cysts with leimyomas?
. Not infrequently these tumors reach quite a large size; in doing so they outgrow their blood supply and may undergo areas of necrosis with ultimate formation of one or more cysts
Describe the cells in LM
Cells are clonal and are estrogen sensitive
Who does LM affect most?
Affect 25-40% of reproductive age women
What happens to LM after menopause?
Are LM solitary or multiple?
The typical LM has what kind of cells?
spindle shaped nuclei with blunt ends—they are said to be “cigar” shaped. There will be no mitotic figures and no nuclear atypia. As said before, there may be large zones of ischemic necrosis or other degenerative change
Leiomyosarcoma can arise anywhere in the body, but is more common in the _____.
uterus, abdomen, pelvis
Survival with LMS depends on what?
tumor size and invasiveness into other structures which affects ability to completely resect the neoplasm. Other important survival indicators include histological grade of the tumor
T or F It is not clear whether LMS arise de novo or whether they arise in preexisiting leiomyomas.
What would a low grade LMS look like histo? High grade?
low: cigar cells with mitotic figures
high: bizarre, unrecognizable smooth muscle origin