Soft Tissue Tumors (Dumbledorf) Flashcards

1
Q

fatty tumors

A

lipoma/liposarcoma

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2
Q

fibrous tumors

A

reactive proliferans/fibromatosies/fibrosarcoma

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3
Q

fibrohistiocytic tumors

A

benign and malignant histiocytoma

dematofibroscarcoma protuberans

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4
Q

smooth muscle tumors

A

leiomyoma/leiomyosarcoma

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5
Q

as mesenchymal proliferations that occur in the extraskeletal, nonepithelialized tissues of the body, excluding the viscera, coverings of the brain, and the lymphoreticular system

A

definition of soft tissue tumors

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6
Q

a connective tissue neoplasm, usually highly malignant, formed by proliferation of mesodermal cells

A

sarcoma

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7
Q

rapidly growing, small, benign, fibrous proliferation on the subcutis, usually encountered as a small mass

A

nodular fascitis

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8
Q

epidemiology of nodular fascitis

A

young adult

*sometime after trauma

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9
Q

Where on the body is nodular fasciitis most commonly seen?

A

arms

**particularly the flexor aspects of the forarms**

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10
Q

What is the key feature that distinguishes myositis ossificans from a malignancy?

A

MATURE, woven bone is well formed at peripher BUT there is IMMATURUE bone at the center

**malignancies lack a maturation pattern **

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11
Q

What are these? What is the major difference?

A

top : liposarcoma (malignant)

bottom: lipoma (benign)

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12
Q
A

Nodular Fasciitis

(rapidly growing, small, benign, fibrous proliferation on the subcutis)

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13
Q
A
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14
Q

fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended, ring finger and pinky finger are most commonly affected

A

Dupuytren contracture

(type fo superficial fibromatosis)

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15
Q

Where do superficial fibromatoses commonly arise?

A

hand, feet, penis

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16
Q

Peyronie disease

A

penile fibromatoses

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17
Q

Ledderhose disease

A

plantar fibromatoses
**younger pts and often bilateral

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18
Q

Dupuytren contractures

A

palmar fibromatoses
**usually presents bilaterally

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19
Q

arise in the digits of infants and young children and are characterized by peculiar inclusion-like condensations of cytoplasmic actin.

A

infantile digital fibromatoses

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20
Q
A

myositis ossificans

Mature, woven bone at periphery (right) and Immature bone at center (left)

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21
Q
A

lipoblast

in liposarcoma

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22
Q

“tissue culture” appearence

A

nodular fascitis (histo)

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23
Q

woven bone in granulation tissue

A

reactive proliferans: myositis ossificans

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24
Q

What is going on in the plam of a hand with a Dupuytren contracture (i.e. what is making the hand look funny?)

A
  1. the tissues under the skin on the palm of the hand thicken and shorten so that the tendons connected to the fingers cannot move freely
  2. The palmar aponeurosis becomes hyperplastic and undergoes contracture
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25
Q

epidemiology of Dupuytren contracture

A

Incidence increases after the age of 40; at this age men are affected more often than women. After the age of 80 the distribution is about even.

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26
Q
A

deep fibromatosis

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27
Q

Where a deep fibromatoses typically found in and what is the sex predominance…

  1. pediatic pts
  2. pts in late 20s
  3. adult years
A
  1. extra abdominal and female
  2. abdominal wall and female
  3. extra abdominal and no sex predominance
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28
Q

a tumor of mesenchymal cell origin that is composed of malignant fibroblasts in a collagen background

A

fibrosarcoma

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29
Q

fibrosarcomas of bone are (painless or painful)

A

painful

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30
Q

fibrosarcomas are a (soft tissue mass or bone tumor)

A

BOTH

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31
Q

Where do fibrosarcomas of bone typically form?

A

lowe extremities, esp femur and tibia

(also, metaphysis of long bones and in the pelvis)

32
Q

epidemiology of fibrosarcoma of bone

A

Men > women

can occur @ any age but most commonly in 30s

33
Q

Where do fibrosarcoma of soft tissue usually arise?

A

thigh and posterior knee

34
Q

Fibrosarcomas of soft tissue are (painless or painful)

A

painless

35
Q

fibrosarcoma of soft tissue is generally found (superfical or deep) to the fascia

A

deep

36
Q

non-cancerous growth of dermal dendritic histiocytic cells

A

dermatofibroma (aka fibrous histiocytoma)

37
Q

Where do dermatofibromas most commonly arise?

A

arms and legs

38
Q

Why will a dimple form in the skin over a dermatofibroma when it is squeezed?

A

the skin is attatched to the underying fibrous tissue

39
Q

What layers of the skin does a dermatofibrosarcoma protuberans affect?

A

arises in dermis and invades deeper subcutaneous tissue (fat, fascia, muscle, bone)

40
Q

cellular origin of dermatofibrosarcoma protuberans

A

fibroblastic, histocytic, or neuralectodermal

OR pluripotential progenitor cells, such as undifferentiated mesenchymal cells

41
Q

fibroblastlike and histiocytelike cells in varying proportions, with spindled and rounded cells exhibiting a storiform arrangement.

A

malignant fibrous histocytoma

42
Q

What is the most significant prognostic factor for a malignant fibrous histiocytoma?

A

stage (defined by grade, size, and +/- mets)

43
Q

Where do malignat fibrous histiocytoma commonly metastazise to?

A

lungs (90%), bone (8%), liver (1%)

44
Q

“fish flesh” appearance.

A

rhabdomyosarcoma

45
Q

“storiform” (woven mat) pattern

A

malignat fibrous histocytoma

46
Q

Reactive bone formation in muscle as a result of injury, usually blunt trauma

A

reactive proliferants: myositis ossificans

47
Q

What cells make up a rhabdomyosarcoma?

A

rhabdomyoblasts

48
Q

What are the most common site for a rhabdomyosarcoma to arise?

A
  1. adjacent to the base of the skull (parameningeal)
  2. around the eye
  3. nose and throat
  4. arms and lefs
  5. GU

sooooo, pretty much anywhere

49
Q

most common place to find leiomyoma

A

uterus

(smooth muscle tumor)

50
Q

Uterine leiomyoma are..

symptomatic, asymptomatic

regress or progress after menopause

estrogen sensitive or insensitive

A

asymptomatic

regress

estrogen senstivie (why they prob regress after menopause)

51
Q

leimyoma affect ____% of reproductve age women

A

25-40%

that shit be cray

52
Q

Leiomyosarcoma can arise anywhere in the body, but is more common in the …

A

uterus, abdomen, or pelvis

53
Q

sarcomas spread via (blood stream or lymphaics)

A

blood stream

54
Q

Where do leiomyosarcomas typically metastasize to?

A

lungs

55
Q

elongated “strap” cells

A

Rhabdomyosarcoma

56
Q

bland histiocytic type cells interdigitate between normal collagen bundles

A

Dermatofibroma (fibrous histiocytoma)
**not as structured/organized a malignant fibrous tumor

57
Q

cigar shaped nuclei

A

Leiomyoma or leiomyosarcoma

58
Q

arises at the site of a minor injury, especially an insect bite or thorn prick

A

Dermatofibroma (fibrous histiocytoma)

59
Q

locally aggressive fibrous tumor with a high recurrence rate;

A

Dermatofibrosarcoma protuberans

60
Q

Can get large enough that they outgrow their blood supply and may undergo areas of necrosis with ultimate formation of one or more cysts

A

Leiomyoma or leiomyosarcoma

61
Q
A

dermatofibroma

62
Q
A

leiomyosarcoma

with partially hemorrhagic necrosis

63
Q
A

fibrosarcoma

“herringbone” pattern

64
Q
A

dermatofibrosarcoma protruberans

shows greater cellularity than dermatofibroma with greater cellular atypia, though without mitotic figures or necrosis.

65
Q
A

dermatofibroma

higher power = bland histiocytic type cells interdigitate between normal collagen bundles

66
Q
A

fibrosarcoma

herringbone pattern

67
Q
A

malignant fibrous histiocytoma

typical bizzare, giant cells

68
Q
A

mailignant fibrous histocytoma

“storiform” pattern

69
Q
A

dermatofibrosarcoma protuberans

70
Q
A

rhabdomyosarcoma

71
Q
A

rhabdomyosarcoma with an elongated “strap” cell

72
Q
A

rhabdomyosarcoma

lots of pink cytoplasm

73
Q
A

leiomyoma with a cyst (arrow) bc it out grew its blood supply

74
Q
A

leiomyosarcoma with cigar shaped nuclei (which are seen in leiomyomas too)

75
Q
A

leiomyoma with cigar shaped cell

76
Q

f

A

fibrosarcoma

herringbne pattern