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32 Cards in this Set
- Front
- Back
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Dermis, subQ
Adult mid-life painless, slow-growing, mobile, up to 1 cm Bland spindle cells in storiform pattern Acanthosis of overlying epidermis |
Benign fibrous histiocytoma (involves langerhan's cells)
aka Dermatofibroma BENIGN |
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Develops suddenly: amazingly fast growing (wks)
Volar aspect of forearm>chest>back Deep dermis, subQ, muscle: 2-3cm Plump fibroblasts growing in short fasciciles Looks like tissue culture Prominent nucleoli, many mitoses |
Nodular (Pseudosarcomatous) Fasciitis
BENIGN |
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Affects more males than females
Fibroblasts with abundant collagen formation Many fibroblasts are myofibroblasts (contractile -> scar/bunch up) |
Superficial Fibromatoses
BENIGN |
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Palmer (Dupuytren contracture)
Planter (Ledderhose disease) Penile (Peronie disease) What type of benign tumors are these?? |
Superficial Fibromatoses:
BENIGN |
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Bilateral sometimes
4th and 5th fingers Evolving contractures requires surgery |
Dupuytren Contracture
BENIGN |
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Usually 45-65
Often hx of injury - concomitant with Dupuytron or Ledderhose in 50% Fibrotic thickening of areas of tunica albuginea Consequences during erection (pain, abnormal bend/shortened, constriction with flail affect) Normal flow proximal and distal to lesion... not a vascular process |
Peronie Disease
BENIGN |
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Abdominal wall - following pregnancy
Extra-abdominal (trunk/thigh) - white rubbery masses, deep in muscle Intra-abdominal (mesentery +/- Gardner syndrome) Fascicles of plump fibroblasts infiltrating muscle locally agressive/highly invasive Triple therapy |
Desmoid Tumors
BENIGN |
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Most common soft tissue tumor of adults
May have chromosomal abnormalities! Soft, mobile, painless Trunk, proximal extermities Mature fat cells |
Lipoma
BENIGN |
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Most common human tumor
1/4 of fertile women (more black) May be genetic abnormalities! Mostly in myometrium of corpus |
Leiomyoma
BENIGN |
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Which two benign tumors have chromosomal/genetic abnormalities?
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Leiomyoma
Lipoma |
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Where does leiomyoma typically metastasize to?
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Uterine leiomyoma erodes into bvs, commonly travels to the lung
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Soft Tissue Tumors: Benign
Benign fibrous ________ Nodular ______ Superficial ________ _______ tumors Lipoma Leiomyoma |
histiocytoma
fasciitis fibromatosis Desmoid tumors |
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Most common sarcoma of adulthood (40-60)
Deep in proximal extremities and retroperitoneum If well-differentiated - indolent Aggressive, may metabolize t(12;16) in 2/3 variants Surgery - usually recur unless adequately excised |
Liposarcoma
MALIGNANT |
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Which malignant soft tissue tumor has a t(12;16)?
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Liposarcoma
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Distinguishable lipoblast in Liposarcoma by the nucleus placed where?
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Nucleus travels centrally - clear lipid stuff is broken up into little fatt packets
Lipocyte has nucleus at the perimeter always |
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Adults (more females)
Skin, deep soft tissue of extermities, retroperitoneum Interweaving fascicles of malignant spindle cells Prognosis related to location and size |
Leimyosarcoma
MALIGNANT |
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Origin is fibroblastic
Mimics other soft tissue sarcomas (dx by exclusion) Muscle of proximal extremities and retroperitoneal (deceptively circumscribed - like benign) Spindle cells (storiform), round cells Aggressive - 30-50% met unless excised fully |
Malignant fibrous histiocytoma
MALIGNANT |
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Extremities, retroperitoneum. Very rare
Invasive, fish-flesh appearance. Foci of hemorrhage, necrosis Increased mitoses, indolent vs highly pleomorphic fibroblasts With or without herringbone pattern Aggressive: recurrence 50%, metastasis > 25% |
Fibrosarcoma
MALIGNANT |
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Older adults: skin, soft tissue, breast, liver
Breast: especially if radiated Arm: 5-10 yrs post radical mastectomy: lymphangiectasia, may be associated with lymphedema, and ultimately with lymphangiosarcoma |
Angiosarcoma
MALIGNANT |
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Gross: early, small red; late, large grey-white. Margins blend imperceptibly. Necrosis, hemorrhage
Micro: vascular channels vs solid spindle (CD31, CD34, vwf +) Grim, few survive more than 5 yrs |
Angiosarcoma: Breast
MALIGNANT |
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What's another term for CD31?
CD34? |
PCAM - platelet endothelial cell adhesion molecule (neutrophils and endothelial cells diapedesis)
CD34 = primitive hematopoeitic cell |
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20-50 years
Vicinity of large joints (knee) - NOT IN THEM Uncertain cellular origin but EMA and kertin + Monophasic - spindle cells Biphasic - spindle cells and glandular structures |
Synovia Sarcoma
MALIGNANT |
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Most common STS of childhood/adolescence
Most occur in head, neck or GU - little/no sk mus component Elsewhere (arms/legs) - related to sk mus Most t(2;13) with PAX3/FKHR fusion Aggressive neoplasms 65% cured with triple tx |
Rhabdomyosarcoma
MALIGNANT |
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Which malignancy is associated with t(2;13) with PAX3/FKHR fusion
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Rhabdomyosarcoma
Failure to differentiate and ultimately may turn into sarcoma |
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Mostly children under 10 (orbit, nose, middle ear, prostate, paratesticular region, vagina)
Commonly allelic loss of 11p15.5 |
Embyronal Rhabdomyosarcoma
MALIGNANT |
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Allelic loss of 11p15.5 creates what condition?
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Embryonal Rhabdomyosarcoma
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Looks like a cluster of grapes protruding into hollow, mucosa-lined structured, bladder, vagina, common bile duct, nasopharynx
Forms cambium layer (zone of hypercellularity) Rhabditiform cells may be present |
Botryoid Rhabdomyosarcoma
MALIGNANT |
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most common in mid-adolescence
Usually in deep musculature of extremities Either t(1;13) or t(2;13) Tumor traversed by fibrous septae Cells moderate in size, many with little cytoplasm Cross striations in about 25% of cases (Synonym...Rhabditiform) |
Alveolar Rhabdomyosarcoma
MALIGNANT |
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Rhabditiform cells appear how?
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Cross-striations
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t(1;13) or t(2;13)
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Alveolar Rhabdomyosarcoma
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Adult variant - very rare
Tends to arise in deep soft tissues Numerous large, often multinucleate, eosinophilic cells (tadpole, tennis-racquet, watch strap) X-striations are diagnostic Prognosis fair to poor with triple Rx |
Pleomorphic Rhabdomyosarcoma
MALIGNANT |
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Soft Tissue Tumors: Malignant
Liposarcoma Leiomyosarcoma Malignant fibrous _______ Fibrosarcoma Angiosarcoma Synovial ______ Rhabdomyosarcoma |
histiocytoma
sarcoma |
