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26 Cards in this Set
- Front
- Back
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Superficial tumors
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Tend to be benign
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Deep lesions
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often malignant
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rapidly growing tumors
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Likely to be malignant
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Calcification
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in both malignant and benign tumors
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benign tumors
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usu. avascular
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malignant tumors
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hypervascularized
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Etiology/pathogenesis of soft tissue tumors
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unknown, most occur sporadically
small minoruty occur with genetic syndrome NF Type I- malignant schwannoma Osler-Weber-Rendu syndrome 0 telangiectasia |
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Location of soft tissue tumors
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40% - lower ext.
20% upperext 10% H&N 30% trunk and retroperitoneum |
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Describe Lipomas
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BENIGN tumors of fat
Most common soft tissue tumor in adulthood some variants have characteristic chromosomal abnormalities (12q14-15, 6p, 13q = conventional lipoma) |
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General features of lipomas
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Maj. seen in Pathology - SQ tumors
middle-aged to elderly pt males = females most located on trunk or upper ext. angiolipoma = forearm spindle and pleomorphic types -> neck Most lipomas consist of mature white fat cells delicate reticulin network each lipocyte completely encircles reticulin/similar to normal fat cells soft, mobile, and painless except angiolipomas usu cured by simple excision |
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What are some examples of BENIGN lipomatous tumors?
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lipoma
lipoblastoma angiolipoma myolipoma chondroid lipoma angiomyolipoma myelolipoma hibernoma spindle cell/pleomorphic lipoma |
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What are some examples of Malignant Lipomatous tumors?
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dedifferentiated liposarcoma
myxoid liposarcoma round cell liposarcoma pleomorphic liposarcoma mixed-type liposarcoma liposarcoma, NOS |
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Some common features of liposarcomas?
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One of most common sarcomas in adults
age 40-60 rare in children usu arise in deep soft tissue/proximal ext. often develop into large tumors MICRO: Can be divided into well-differentiated myxoid, round cell and pleomorphic variants. Some cells indicative of fatty differentiation -> LIPOBLASTS/cytoplasmic vacuoles -> scallop the nucleus |
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Describe Nodular Fasciitis
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benign condition but rapidly growing reactive lesion**
probably results from trauma effects superficial tissues - forearm, trunk, back msotly adults Can be mistaken for a sarcoma microscopically |
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What are some gross and micro features of Nodular Fasciitis?
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Gross: Several cm in size
poorly defined margins Micro: richly cellular consists of plump, immature-appearing fibroblasts randomly arranged or in short intersecting vesicles lesion is reactive/rarely occurs after excision. Mixed with a few lymphoid cells vascular channels abundant mitoses numerous pleomorphic, splindle-shaped cells |
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General characteristics of Myositis Ossificans
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Different from other fibroblastic proliferations
presence of METAPLASTIC BONE*** usu. develops in athletic kids/young adults. follows episode of trauma<50% of cases typically in muscles of proximal ext. early phase -> swollen and painful late phase -> circumscribed, firm -> painless, hard, well demarcated mass |
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Radiographic and other findings for Myositis ossificans?
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radiographic findings -> parallel the morphologic progression
initially: only shows sft tissue fullness @ 3 weeks -> patchy flocculent radiodensities in periphery radiodensities -> become more extensive and encroach on center MUST be distinguished from a extraskeletal osteosarcoma simple excision will usu cure. |
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Key feature for distinguishing Myositis ossificans from a neoplasm?
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Bone matures peripherally, but is immature or not formed at all in center, called the Zonation effect. Indicates a reactive process. NEOPLASM HAS THE OPPOSITE EFFECT, where most mature tissue is located centrally.
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Describe a superficial fibromatosis.
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Palmar, Plantar, Penile
Small group Nodule of poorly defined broad fascicles mature appearing fibroblasts surrounded by dense collagen genetically distinct from deep-seated counterpart |
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Describe the Palmar variant of a superficial fibromatosis.
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Irregular or nodular thickening of the palmar fascia
unilateral and bilateral attachment to overlying skin -> puckering and dimpling simultaneously -> slowing progressive flexion contracture of 4-5 digits |
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Describe the Plantar variant of a fibromatosis.
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Ledderhose's disease - flexiion contractures uncommon. rarely bilateral.
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Describe a deep-seated Fibromatosis, or Desmoid Tumors
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Lie between aggressive fibrous tumors and low grade fibrosarcomas
composed of bland looking fibroblasts can recur after incomplete excisions occur at any age, but usually teens-30 |
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Describe a Fibrosarcoma
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rare tumor, but commonly tumors of adults
may occur anywhere in body usu in retroperineum, thigh, knee, and distal ext. MACRO: unencapsulated, infiltrative, soft, fish-flesh masses w/ areas of hemorrhage and necrosis. HERRINGBONE PATTERN: Marked disarray with mitoses and areas of necrosis. |
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Describe Fibrohistiocytic Tumors
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contain cellular elements -> resemble both fibroblasts and histiocytes
studies suggest that the phenotype of the neplastic cells most closely resemble that of fibroblasts. Term fibrohistiocytic -> should be viewed as descriptive in nature Assoc w/ basaloid proliferation of the overlying skin. NOT A BASAL CELL CARCINOMA |
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Dermatofibroma - what is it?
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round brownish/purplish growth
usu on legs and arms, of cosmetic significance usu persist for years as firm feeling nodules NEvER TURN TO CANCER |
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Describe malignant fibrous histiocytomas
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most common type of soft tissue sarcomas.
several morphologic variants of MFH. Storiform-pleomorphic MFH -> the prototypic and most common member of this group. occus in deep soft tissues of ext in adults. peak in 7th decade but have been seen in children. |
