Soft Tissue Tumors (Dumbledorf) Flashcards Preview

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Flashcards in Soft Tissue Tumors (Dumbledorf) Deck (76):
1

fatty tumors

lipoma/liposarcoma

2

fibrous tumors

reactive proliferans/fibromatosies/fibrosarcoma

3

fibrohistiocytic tumors

benign and malignant histiocytoma

dematofibroscarcoma protuberans 

4

smooth muscle tumors

leiomyoma/leiomyosarcoma 

5

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

definition of soft tissue tumors

6

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

sarcoma 

7

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

nodular fascitis

8

epidemiology of nodular fascitis

young adult 

*sometime after trauma

9

Where on the body is nodular fasciitis most commonly seen?

arms

**particularly the flexor aspects of the forarms**

10

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

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

**malignancies lack a maturation pattern **

11

What are these? What is the major difference?

 

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top : liposarcoma (malignant)

bottom: lipoma  (benign) 

 

12

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Nodular Fasciitis 

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

13

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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 

Dupuytren contracture 

(type fo superficial fibromatosis) 

15

Where do superficial fibromatoses commonly arise?

hand, feet, penis 

16

Peyronie disease

penile fibromatoses

17

Ledderhose disease

plantar fibromatoses
**younger pts and often bilateral 

18

Dupuytren contractures

palmar fibromatoses
**usually presents bilaterally

19

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

infantile digital fibromatoses

20

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myositis ossificans

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

21

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lipoblast

in liposarcoma 

22

"tissue culture" appearence 

nodular fascitis (histo)

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woven bone in granulation tissue

reactive proliferans: myositis ossificans

24

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

  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

25

epidemiology of Dupuytren contracture 

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.

26

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deep fibromatosis 

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

  1. pediatic pts
  2. pts in late 20s
  3. adult years

  1. extra abdominal and female
  2. abdominal wall and female
  3. extra abdominal and no sex predominance 

28

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

fibrosarcoma

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fibrosarcomas of bone are (painless or painful)

painful

30

fibrosarcomas are a (soft tissue mass or bone tumor)

BOTH

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Where do fibrosarcomas of bone typically form?

lowe extremities, esp femur and tibia

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

32

epidemiology of fibrosarcoma of bone

Men > women

can occur @ any age but most commonly in 30s

33

Where do fibrosarcoma of soft tissue usually arise?

thigh and posterior knee

34

Fibrosarcomas of soft tissue are (painless or painful)

painless

35

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

deep

36

non-cancerous growth of dermal dendritic histiocytic cells

dermatofibroma (aka fibrous histiocytoma) 

37

Where do dermatofibromas most commonly arise?

arms and legs

38

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

the skin is attatched to the underying fibrous tissue 

39

What layers of the skin does a dermatofibrosarcoma protuberans affect?

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

40

cellular origin of dermatofibrosarcoma protuberans 

fibroblastic, histocytic, or neuralectodermal 

OR pluripotential progenitor cells, such as undifferentiated mesenchymal cells

41

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

malignant fibrous histocytoma 

42

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

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

43

Where do malignat fibrous histiocytoma commonly metastazise to?

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

44

"fish flesh” appearance.

rhabdomyosarcoma 

45

“storiform” (woven mat) pattern 

malignat fibrous histocytoma 

46

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

reactive proliferants: myositis ossificans 

47

What cells make up a rhabdomyosarcoma?

rhabdomyoblasts

48

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

  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

most common place to find leiomyoma

uterus

(smooth muscle tumor)

50

Uterine leiomyoma are..

symptomatic, asymptomatic 

regress or progress after menopause

estrogen sensitive or insensitive

asymptomatic

regress

estrogen senstivie (why they prob regress after menopause)

51

leimyoma affect ____% of reproductve age women

 

25-40%

that shit be cray

52

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

uterus, abdomen, or pelvis

53

sarcomas spread via (blood stream or lymphaics) 

blood stream 

54

Where do leiomyosarcomas typically metastasize to?

lungs 

55

elongated “strap” cells

Rhabdomyosarcoma 

56

bland histiocytic type cells interdigitate between normal collagen bundles

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

57

cigar shaped nuclei

Leiomyoma or leiomyosarcoma 

58

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

Dermatofibroma (fibrous histiocytoma)

59

locally aggressive fibrous tumor with a high recurrence rate;

Dermatofibrosarcoma protuberans 

60

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

Leiomyoma or leiomyosarcoma 

61

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dermatofibroma 

62

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leiomyosarcoma 

with partially hemorrhagic necrosis

63

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fibrosarcoma 

"herringbone" pattern 

64

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dermatofibrosarcoma protruberans 

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

65

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dermatofibroma 

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

66

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fibrosarcoma

herringbone pattern 

67

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malignant fibrous histiocytoma 

typical bizzare, giant cells 

68

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mailignant fibrous histocytoma 

"storiform" pattern 

69

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dermatofibrosarcoma protuberans 

70

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rhabdomyosarcoma 

71

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rhabdomyosarcoma with an elongated "strap" cell 

72

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rhabdomyosarcoma 

lots of pink cytoplasm 

73

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

74

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

75

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leiomyoma with cigar shaped cell 

76

f

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fibrosarcoma 

herringbne pattern