High Yield Soft Tissue

Front 1

good ihc markers for nerve sheath tumors (general)

Back 1

S100, CD34, NFP, GFAP, EMA

Front 2

what histochemical stain can be used for alveolar soft parts sarcoma

Back 2

pas for crystals

Front 3

stains for epithelioid sarcoma

Back 3

Keratin, EMA, Vimentin, CD34

Front 4

ihc for synovial sarcoma

Back 4

Keratins, CK7, EMA

Front 5

ihc for clear cell sarcoma

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HMB45 >S100 protein

Front 6

ihc fo4 Angiomatoid (Malignant) Fibrous
Histocytoma

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50% desmin

Front 7

three fx for grading sarcomas

Back 7

Differentiation
Mitotic activity
Necrosis

Front 8

examples of some grade 2 sarcomas

Back 8

MFH, myxoid sarcomas, MPNST, and
angiosarcoma

Front 9

of soft tissue sarcomas which are generally hematogenous

Back 9

i hope i got this right
epitheloid and melanocytic (most others go to LNs)?

Front 10

which sarcomas are not staged

Back 10

Angiosarcoma, DFSP, IMFT, desmoid, and
sarcoma of parenchymal organs

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primary stage determinant in sarcoma

Back 11

tumor size

Front 12

for treatment, when do more than just surgery

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i believe usually when you get to intermediate, then employ rad/chemo

Front 13

ihc for sarcomatoid scca

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AE1/AE3, Keratin (CK) 5/6, p63

Front 14

IHC for spindle cell adenoca

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AE1/AE3, CK18 alone

Front 15

if see dirty necrosis and cherry red nuclei, these are fx of what 2 general categories

Back 15

carcinoma, melanoma

Front 16

ihc for DLBL

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CD20, CD79a, CD10, Bcl6, Bcl2

Front 17

ihc for anaplastic large cell lymphoma

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CD30, ALK-1, EMA

Front 18

what

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analplastic large cell lymphoma: dishesive and hallmark cells

Front 19

what in lymphoma

Back 19

dot and membrane staining with CD30 in anaplastic large cell lymphoma

Front 20

ihc of MFH:

Back 20

vimentin, focal S MA or MSA only,
diagnosis of exclusion

Front 21

ihc of Liposarcoma:

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S100 in lipoblasts, CD34 in
spindled cells

Front 22

ihc of Rhabdomyosarcoma:

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Desmin, MSA, MyoD1, myf4 (skeletal muscle specific
myogenin)

Front 23

ihc of Leiomyosarcoma

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: Desmin, SMA, MSA

Front 24

ihc of Epithelioid Malignant Peripheral Nerve
Sheath Tumor

Back 24

S100 protein, GFAP

Front 25

five patterns of MFH

Back 25

• Pleomorphic Sarcoma NOS (Storiform-
Pleomorphic MFH)
• Myxofibrosarcoma (Myxoid MFH)
• Giant Cell Rich
• Angiomatoid (Malignant) Fibrous
Histiocytoma

Front 26

most common type of MFH

Back 26

storiform/pleomorphic (90% are deep, intramuscular)

Front 27

in whom does angiomatoid MFH occur

Back 27

kids

Front 28

what

Back 28

pleomorphic/storiform MFH

Front 29

if subcutaneous MFH usually what type

Back 29

myxoid MFH

Front 30

role of CD68 and CD163 in MFH

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CD68 stains lots of mesenchymal cells, relatively nonspecific, stains cells with lysosomes
CD163 specific histiocyte marker, MFH cells are negative

Front 31

what, where located

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50% myxoid histology, extremities, superficial location

Front 32

what

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myxofibrosarcoma - Prominent ropy vasculature “dripping” with tumor cells

Front 33

another name for low grade fibromyxoid sarcoma

Back 33

EVANS TUMOR, ON SPECTRUM
WITH HYALINIZING SPINDLE CELL
TUMOR WITH GIANT ROSETTES)

Front 34

cytogenetic findings in fibromyxoid sarcoma

Back 34

t(7;16)(q33;p11) FUS/CREB3L2

Front 35

what

Back 35

low grade fibromyxoid sarcoma

Front 36

what

Back 36

Hyalinizing Spindle Cell
Tumor with Giant Rosettes (on spectrum with low grade fibromyxoid sarcoma)

Front 37

what

Back 37

GC rich MFH
=storiform/pleomorphic MFH+ osteoclast-like GCs

Front 38

what, ddx

Back 38

inflammatory MFH: retroperitoneal, CD30+, CD15-
sheets of polys and xanthoma cells
clinically: systemic fx b sx, peripheral eos.
ddx: dediff liposarcoma, Hodgkin dz

Front 39

how do sarcomas usually met

Back 39

hematogenously

Front 40

what

Back 40

atypical fibroxanthoma
Solar Elastosis
Small size <1-2 cm and
Superficial dermal location:

Front 41

cf pleomorphic liposarcoma from dedifferentiated liposarcoma

Back 41

pleomorphic is just that - crazy cells
dedifferentiated floret-like GCs

Front 42

ST leiomyosarcoma - mits

Back 42

low tolerance for mits; cyto atypia with 1 mit/50 malignant involving cutaneous/dermis
pilar, angio or genital are exceptions

Front 43

cytogenetics with pleomorphic rhabdomyosarcoma

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CHOP

Front 44

age group for pleomorphic rhabdomyosarcoma, ihc

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>40 years, if mismatch between smooth muscle tumors, think skeletal

Front 45

two pleomorphic sarcomas with worst prognoses

Back 45

Pleomorphic Leiomyosarcoma
AND
Pleomorphic Rhabdomyosarcoma

Front 46

ddx for fascicular malignant spindle cell tumors

Back 46

“Fibrosarcoma”
Malignant peripheral nerve sheath tumor
(MPNST)
Synovial sarcoma
Kaposi sarcoma

Front 47

if see a "fibrosarcoma" close to dermis, what is it

Back 47

DFSP

Front 48

"fibrosarcomas" have been stratified into what four tumors

Back 48

Sclerosing epithelioid fibrosarcoma
Myxofibrosarcoma
Low grade fibromyxoid sarcoma
(Evans Tumor)
Fibrosarcoma arising in
Dermatofibrosarcoma Protuberans

Front 49

DERMATOFIBROSARCOMA PROTUBERANS - in whom, where found, marker

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males, Old Fashioned Bathing-Suit Distribution, pdgf-beta

Front 50

some growth patterns for dfsp

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honeycomb, storiform

Front 51

ihc for dfsp

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cd34 - goes away if portion develops into Fibrosarcoma (which is present portends a worse prognosis)

Front 52

cytogenetics of DFSP

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Ring chromosome: COL1A1-PDGFB fusion t(17;22)(q22;q13)

Front 53

S100 and MPNST

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if spindled (which most are), only focal S100. If epitheloid very S100.
those that arise in NF1 are spindled

Front 54

what

Back 54

MPNST - note nerve on side

Front 55

what, ddx

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MPNST,
can see donut growth (geographic necrosis/not dirty though) in syn sarc and PNETs too

Front 56

what

Back 56

MPNST+rhabdo=malignant triton tumor

Front 57

what

Back 57

syn sarcoma (biphasic)

Front 58

what, CD7+, ema+, CD34-, czome?

Back 58

monphasic synovial sarcoma t(x;18), SYT-SSX fusion

Front 59

four clinical settings for kaposi sarcoma

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Classic (Chronic) - middle age, men, meditteran
AIDS related
Post-Transplant
Lymphadenopathic (african)
same histol. etc

Front 60

what

Back 60

kaposi
fascicles of
spindle cells, separated
by slit-like vascular
spaces containing
erythrocytes, PAS
positive diastase
resistant hyaline
globules, extravasated
RBCs, scattered plasma
cells, and hemosiderin
deposits
breakdown of rbcs, hyaline globules, like pink grapes, think mediterrean

Front 61

name 4 benign fascicular tumors

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Fibrous Histiocytoma
Fibromatosis
Neurofibroma
Schwannoma

Front 62

what

Back 62

benign fibrous histiocytoma - note pushing stellate border

Front 63

ihc for deep fibromatosis, syndromic assoc, gene alterations

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nuclear beta catenin, apc, gardners (and sporadic)

Front 64

what, ihc

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Neurofibroma, note how central portion is more cellular, S100, CD34

Front 65

name, dz

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wagner meisser corposcle
diffuse nf

Front 66

skin findings of NF1

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Café-au-lait macules appear
shortly after birth
lisch nodules, axillary freckle and neurofibromas occur in childhood or at puberty

Front 67

findings in NF1 (not skin)

Back 67

Neurofibromas
Optic glioma (pilocytic astrocytoma)
Bone changes: osteoporosis, kyphoscoliosis, and pseudoarthrosis (tibia)
Vasculopathy: arterial dysplasia, spontaneous rupture (renal, cerebral vessels)

Front 68

mutation in NF1

Back 68

loss of neurofibromin Nf1 (generally
suppresses Ras), chromosome 17, Tumor
Suppressor Gene

Front 69

what

Back 69

schwannoma

Front 70

what

Back 70

hyaline vascularization in antoni B (myxoid area) of Schwannoma

Front 71

what

Back 71

pericapsular lymphoid cuffing in cellular schwannoma

Front 72

ihc for schwannoma

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- S100 protein diffuse
– CD34 only in Antoni B
– EMA at periphery in capsule
(perineurium)
– Cellular schwannoma has diffuse S100
protein, GFAP, and occasionally keratin
reactivity

Front 73

what

Back 73

Madelung Lipomatosis, posterior shoulder, can be assoc with etoh

Front 74

cytogenetic changes in spindle cell lipoma/pleomorphic lipoma

Back 74

13q changes and 16q
losses with partial monosomy

Front 75

what

Back 75

chondroid lipoma

Front 76

kidney, ihc, syndrome

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histo: thick walled vessels, 2) immature specialised smooth muscle cells which may be pleomorphic , 3)mature fat
ihc: desmin, HMB45
syndrome: TS

Front 77

what

Back 77

myxoid liposarcoma, plexiform vessels, t(12;16)

Front 78

what, cytogenetics

Back 78

round cell liposarcoma, t(12;16), CHOP by FISH

Front 79

Mesenchymal chondrosarcoma ihc

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SOX9

Front 80

Evans low grade fibromyxoid sarcoma FISH

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FUS

Front 81

ihc for ewings

Back 81

vimentin, keratins, CD99, glycogen
pnet same but add in neural markers or EM

Front 82

name 4 ish tumors that have the t(12;22)(q13;q12)
EWS-ATF1 fusion finding

Back 82

Ewings/PNET
angiomatoid MFH
clear cell sarcoma

Front 83

name 4 ish tumors with the same t(12;15)(p13;q25) ETV6-NTRK3 fusion

Back 83

Infantile fibrosarcoma
Congenital mesoblastic nephroma
Acute myeloid leukemia
Secretory breast carcinoma

Front 84

name two tumors with t(X;17)(p11.2;q25)ASPL-TFE3 fusion

Back 84

Alveolar soft part sarcoma
Papillary renal cell carcinoma

Front 85

two mutations in syn sarcoma

Back 85

t(2;13)(q35;q14)
– PAX3-FKRH
t(1;13)(p36;q14)
– PAX7-FKRH

Front 86

what

Back 86

Nodular fasciitis;
MYXOID DEGENERATION
EXTRAVASATED ERYTHROCYTES AND
LYMPHOCYTES

Front 87

honeycomb pattern in subcutis

Back 87

DFSP
Neurofibroma

Front 88

cf diffuse NF vs. DFSP

Back 88

cd34 in both
s100 negat in dfsp, S100 pos in nf
look for weigner-m. corpusles in diffuse nf

Front 89

see keloidal collagen think:

Back 89

Keloid
nodular
fasciitis
fibromatosis,

Front 90

see central necrosis think:

Back 90

Epithelioid Sarcoma
Necrobiotic Granuloma (CD163, CD68 positive, negative for keratin, EMA)
Diabetic Lipoidica,
Rheumatoid Nodule,
Infection,
Granuloma Annulare

Front 91

see extravascated rbcs, think:

Back 91

Nodular fasciitis
Myxoid desmoid
Kaposi Sarcoma