Soft Tissue And Bone Tumors

Front 1

t(X;17)(p11.2;q25) - ASPL-TFE3 fusion gene

Back 1

Alveolar soft parts sarcoma

Front 2

t(12;16)(q13;p11) - FUS-ATF1 fusion gene

Back 2

Angiomatoid fibrous histiocytoma

Front 3

t(9;22)(q22;q12) - CHN-EWS fusion gene

Back 3

Chondrosarcoma, myxoid, extraskeletal

Front 4

t(12;22)(q13;q12) ATF1/EWS

Back 4

Clear cell sarcoma

Front 5

t(11;22)(p13;q12) EWS/WT1

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Desmoplastic small round cell tumor

Front 6

t(11;22)(q24;q12) FLI1/EWS

Back 6

Ewing’s sarcoma/PNET, extraosseous

Front 7

t(2;13)(q37;q14) PAX3/FKHR

t(1;13)(p36;q14) PAX7/FKHR

Back 7

Rhabdomyosarcoma, alveolar

Front 8

t(X;18)(p11.23;q11) - SYT-SSX1

Back 8

Synovial sarcoma

Front 9

t(1;2)(p11;q35-37)

Back 9

Tenosynovial giant cell tumor

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Back 10

Front 11

A two year old child had an abdominal mass, which was excised.
Molecular: 1p36.33 deletion, N-myc amplification, 14p deletion

Back 11

Neuroblastoma
Positive: chromogranin, synaptophysin, neurofilament and neuron-specific enolase, as well as vimentin and ALK
negative: keratin, CD45, CD99 and desmin

Front 12

Back 12

Nodular fasciitis
It is highly cellular and composed of plump, immature fibroblasts or myofibroblasts, with a feathery pattern due to the abundance of ground substance. The tumor cells usually have prominent nucleoli. There is often a myxoid stroma, frequent mitotic figures but no atypical forms, a lymphocytic infiltrate and red blood cell extravasation. The vasculature is usually prominent. There may be bands of collagen similar to keloid scars, or metaplastic bone

Front 13

The spindle cells had diffuse cytoplasmic immunoreactivity for CD68 and calponin, and were negative for S100 and pan-keratin. CD34 highlighted the blood vessels.

Back 13

Nodular fasciitis

Front 14

Fascial tissue with infiltrates of fibroblasts and myofibroblasts

Back 14

Palmar fibromatosis (Dupuytren's contracture)

Front 15

Back 15

Deep fibromatosis (musculoaponeurotic)
vague fascicles of (myo)fibroblasts.
Infiltrative borders
separated by
abundant amount of collagen

Front 16

33 year old woman had a 2.4 cm. soft tissue mass of the cheek. Her past medical history was remarkable only for a remote mitral valve replacement. The mass had been present for a while, but recently grew in size
Immunohistochemistry: CD34 positive; negative for Factor XIIIa and CD68

Back 16

Solitary fibrous tumor of the dermis

Front 17

herringbone growth pattern
compact fascicles of spindled cells with
uniform nuclear features.
minimal intervening stroma.
variably immunoreactive for smooth muscle actin.

Back 17

Fibrosarcoma

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Back 18

Fibrosarcoma

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Back 19

Benign fibrous histiocytoma: Polymorphous population of histiocytoid and spindled
cells, Touton giant cells and chronic inflammatory
cells.

Front 20

Positive stains: CD34 (strong in 95%), vimentin; also actin (focal), ApoD, bcl2, NKI-C3 (AJCP 1992;97:478), CD99
Negative stains: Factor XIIIa (usually), keratin, EMA, S100, HMB45, desmin, CD117

Back 20

Dermatofibrosarcoma protuberans (DFSP):
prominent storiform pattern of monomorphic fibroblast-like cells that invade into subcutis
Bednar’s tumor: 5-10% of cases; pigmented variant due to dendritic cells with melanin, S100+ only in pigmented cells, HMB45 negative; associated with black patients

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Back 21

Hematoxylin-eosin stained sections of gastrointestinal stromal tumors (GIST) (a) and solitary fibrous tumors (SFT) (m). The tumor cells in GIST were immunoreactive for CD117 (b), but tumor cells in SFT were nonimmunoreactive (n). All SFT were immunoreactive for CD99 (o), but some GIST were nonimmunoreactive for this marker (c). Strong immunoreactivity for CD34 was present in most of SFT (p) and GIST (d) (a–p, original magnification ×40)

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Back 22

Myositis ossificans is a benign, ossifying soft-tissue lesion typically occurring within skeletal muscle. Patients are usually adolescents and young adults; myositis ossificans is rare in children under 10 years of age. The most frequent symptoms and signs are pain and tenderness with a soft tissue mass. Approximately 80% of cases arise in the large muscles of the extremities.

Front 23

Positive stains: CD34 (strong in 95%), vimentin; also actin (focal), ApoD ,bcl2, NKI-C3 (AJCP 1992;97:478), CD99

Negative stains: Factor XIIIa (usually), keratin, EMA, S100, HMB45, desmin, CD117

Back 23

Dermatofibrosarcoma protuberans (DFSP)

Front 24

Myxoid liposarcoma

Back 24

t(12;16)(q13;p11) TLS/CHOP

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Back 25

Paraganglioma.
Nests of polygonal tumor cells with nuclear atypia and eosinophilic cytoplasm create a Zellballen pattern.