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12 Cards in this Set
- Front
- Back
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soft tissue lesions |
innumerable lumps and bumps of soft tissue, named after the tissue they resemble; REACTIVE/NON NEOPLASTIC= ganglion cysts, GCTTS/PVNS, nodular fascitis/myocitis ossificans, fibromatoses; NEOPLASTIC= benign (common all ages), malignant (rare); many have classic clinical scenarios |
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nodular fasciitis/myositis ossificans |
RAPIDLY DEVELOPING lesions, mostly in young, mostly after trauma; cytologically scary if biopsied; NODULAR FASIITIS= rapidlydeveloping nodule on forearm, about 2 cm; MYOSITIS OSSIFICANS= rapidly developing nodule often in muscle, deep thigh, after trauma, peripheral bone formation (zonation), scary histology early |
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firbomatoses |
aka cellular fibrous lesions; locally aggressive but not malignant (i.e. never metastasize); superficial= palmar (DUPUYTREN contracture), plantar, penile; deep= aka dermoids, abdominal (wall) in pregnant women, extra abdominal in deep extremities, intra abdominal (APC gene, Gardner syndrome association, beta catenin nuclear positive) |
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soft tissue neoplasms- benign |
most common benigns are hemangiomas in kids and lipomas in adults; peripheral nerve cells can become neurofibromas or schwannomas; there are zillions of others some of which are specific for children |
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schwannomas |
ENCAPSULATED; NEUROFIBROMATOSIS TYPE 2 (acoustic neuroma (aka inside your skull)); sporadic peripheral too; solitary |
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neurofibroma |
NOT ENCAPSULATED; Nuerofibromastosis 1; plexiform neurofibromas can undergo malignant transformation sometimes |
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soft tissue sarcomas: age, where are they found, which ones are most common, where do they metastasize |
rare; older adults >40 y/o; trunk and proximal extremities; liposarcoma and MFH most common; metastasize to lungs, elsewhere via blood stream LESS often to lymph nodes (compare to carcinomas) |
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soft tissue sarcomas: treatment, prognosis |
surgery first line of defense then chemo and radiation; the prognosis is worse if DEEPER site of origin (subcutaneous= superficial, deep muscle is deep, retroperitoneum is the deepest), LARGER (usually >5 cm), select tumors are worse than others (ANGIOSARCOMA has terrible prognosis) |
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sarcomas: how are they named/diagnosed |
overall cell pattern; identify cell type; cytogenetics may be useful; many cannot be classified; type and grade GENERALLY not as important as size and site AT THIS TIME |
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sarcoma: newest approaches to separate tumor types |
use of chromosomal abnormalities to better separate tumor types; ex. ex synovial sarcoma t(x;18)(p11.2;q11.2), SYT-SSX1 or SSX2 fusions; ex ewing soft tissue/PNET t(11;22)(q24;q12), EWS-FL1 fusions; NEED TO KNOW THESE ABNORMALITIES (she only named the translocations though and not the other letters/numbers |
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sarcomas: exceptions to the rules |
RHABDOMYOSARCOMA in children= chemo SENSITIVE, embryonal variant (another small round blue cell tumor of childhood, head/neck, prostate in boys, vagina in girls aka sarcoma botyroides (grape like excrescences)); PNETs CHILDREN/ADOLESCENTS; synovial sarcoma= most in EXTREMITIES, often DISTAL hands and feet, young adults, biphasic tumors (spindle and epithelioid pattern) or monophasic spindle cells, unique cytogenetic abnormalities t(X;18), DOES NOT ARISE FROM SYNOVIUM |
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synovial sarcoma |
DOES NOT ARISE FROM SYNOVIUM; mostly monophasic (spindle cells); cytokeratin positive (tiny focus of epithelioid change); t(X;18) |
