Slide1 l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 46

Soft Tissue Tumors PowerPoint PPT Presentation


  • 453 Views
  • Updated On :
  • Presentation posted in: General

Soft Tissue Tumors. Lucy H. Liu, M.D. Department of Pathology University of Illinois at Chicago e-mail: [email protected] Soft Tissue Tumors. UIC College of Medicine M2 Pathology Course, Lecture # 63 Tuesday, January 28, 2003 11:30 am. Soft Tissue Tumors. Lecture Goals:

Download Presentation

Soft Tissue Tumors

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Slide1 l.jpg

Soft Tissue Tumors

Lucy H. Liu, M.D.

Department of Pathology

University of Illinois at Chicago

e-mail: [email protected]


Slide2 l.jpg

Soft Tissue Tumors

UIC College of Medicine

M2 Pathology Course, Lecture # 63

Tuesday, January 28, 2003

11:30 am


Soft tissue tumors l.jpg

Soft Tissue Tumors

Lecture Goals:

1. Nomenclature & classification system of tumors

2. Differences between benign and malignant tumors

3. Clinical & morphologic features of common tumors

4. Approach to diagnosis of soft tissue tumors


Soft tissue tumor l.jpg

Soft Tissue Tumor

  • Neoplastic conditions arising in

  • extraskeletal mesodermal tissues

-- Fibrous tissue

-- Smooth muscle

-- Skeletal muscle

-- Adipose tissue

-- Blood & lymphatic vessels

-- Peripheral nerves - neuroectoderm


Soft tissue tumor5 l.jpg

Soft Tissue Tumor

General principles for diagnosis:

  • Location

-- Deep lesions tend to be malignant

-- Superficial lesions - benign

  • Size

-- Larger tumors tend to be malignant

  • Growth pattern

-- Rapidly growing - malignant

-- Infiltrating - malignant

  • Metastasis

-- Malignant


Soft tissue tumors6 l.jpg

Soft Tissue Tumors

Approach to Diagnosis

  • Histological morphology

  • Immunohistochemistry

  • Cytogenetic study

  • Molecular analysis

  • Ultrastructure


Soft tissue tumors7 l.jpg

Soft Tissue Tumors

Immunohistochemistry

  • Cytokeratin

  • Vimentin

  • Smooth muscle actin

  • Desmin

  • S-100

  • CD 31

  • CD 34


Soft tissue tumors8 l.jpg

Soft Tissue Tumors

Cytogenetic Changes

  • t( 2:13) Alveolar rhabdomyosarcoma

  • t( 11;22) Ewing’s sarcoma/PNET

  • t( 11;22) Desmoplastic small round cell tumor

  • t( 12;16) Myxoid liposarcoma

  • t( 9;22) Myxoid chondrosarcoma

  • t(12;22) Clear cell sarcoma

  • t( X;18) Synovial sarcoma


Nodular fasciitis l.jpg

Nodular Fasciitis

  • Benign reactive soft tissue lesion

  • Probably secondary to trauma

  • On forearm, trunk, back- well circumscribed

  • Spindle cells ( fibroblasts & myofibroblasts)

    in loose matrix -“fibroblasts in tissue culture”

  • Rapid growth, frequent mitotic figures

  • Self-limited, cured by excision

  • Must differentiate from a sarcoma


Slide10 l.jpg

Nodular Fasciitis


Fibromatosis l.jpg

Fibromatosis

  • Fibroproliferative lesions

  • Fibroblasts & Myofibroblasts

  • Infiltrative growth pattern

  • Tendency to recur

  • Desmoid - Infiltrative masses

    in abdominal, extra-abdominal

    & intra-abdominal

  • Palmar, plantar fibromatosis

  • Surgical excision


Slide12 l.jpg

Fibromatosis


Fibrosarcoma l.jpg

Fibrosarcoma

  • Malignant tumor of fibroblast origin

  • In adults, in lower extremities,

    upper extremities, trunk

  • Spindle cells in a herringbone pattern

  • Increased cellularity, high

    nuclear-cytoplasmic ratios

  • Must exclude other tumors which

    resemble fibrosarcoma

    - Peripheral nerve sheath tumor

    - Synovial sarcoma


Slide14 l.jpg

Fibrosarcoma


Dermatofibroma l.jpg

Dermatofibroma

  • Benign fibrous histiocytoma

  • Usually in skin

  • Mixture of fibroblasts,

    myofibroblasts, histiocytes

  • Surgical excision


Slide16 l.jpg

Dermatofibroma


Dermatofibrosarcoma protuberans dfsp l.jpg

Dermatofibrosarcoma Protuberans (DFSP)

  • Fibrohistiocytic tumor

  • Intermediate malignant potential

  • In skin & subcutis

  • Spindle cells in storiform pattern

  • Local recurrence

  • CD 34

  • Transformation to fibrosarcoma

  • Surgical excision


Slide18 l.jpg

Dermatofibrosarcoma Protuberans ( DFSP )


Malignant fibrous histiocytoma l.jpg

Malignant Fibrous Histiocytoma

  • Malignant soft tissue tumor with

    histocytic differentiation

  • Most common type of soft-tissue sarcoma

  • Most frequently encountered sarcoma

    post radiation therapy

  • In adults, in deep soft tissue

    - extremities & retroperitoneum

  • Marked pleomorphism, spindle cells,

    storiform, myxoid


Slide20 l.jpg

MFH


Leiomyoma l.jpg

Leiomyoma

  • Benign soft tissue tumor

  • Arising in subcutaneous tissue

    or blood vessel wall

  • Usually painful

  • Fascicles of regular smooth muscle cells


Slide22 l.jpg

Leiomyoma


Leiomyosarcoma l.jpg

Leiomyosarcoma

  • Malignant soft tissue tumor

  • Arising in extremities of blood

    vessel wall

  • Necrosis, hemorrhage

  • Fascicles, nuclear atypia

  • High mitotic activity


Slide24 l.jpg

Leiomyosarcoma


Rhabdomyosarcoma l.jpg

Rhabdomyosarcoma

  • Malignant tumor of striated muscle

    differentiation

  • In children & young adults

  • Several subtype

    - Embryonal

    - Alveolar

    - Botryoid

    - Pleomorphic


Embryonal rhabdomyosarcoma l.jpg

Embryonal Rhabdomyosarcoma

  • Most common in children,

    in head & neck

  • Most common subtype

  • Rhabdomyoblasts with

    cytoplasmic cross-striation


Slide28 l.jpg

Embryonal rhabdomyosarcoma


Botryoid rhabdomyosarcoma l.jpg

Botryoid Rhabdomyosarcoma

  • Most common in hollow visceral

    organs - genitourinary tract

  • Polypoid, grape-like tumor masses

  • Scattered malignant cells in myxoid

    stroma


Slide30 l.jpg

Botryoid rhabdomyosarcoma


Alveolar rhabdomyosarcoma l.jpg

Alveolar Rhabdomyosarcoma

  • In extremities

  • Fibrous septa with loose clusters of

    rounded cells in center

    - alveolar pattern


Slide32 l.jpg

Alveolar rhabdomyosarcoma


Pleomorphic rhabdomyosarcoma l.jpg

Pleomorphic Rhabdomyosarcoma

  • In skeletal muscles of older

    persons, in thigh

  • Marked pleomorphism

  • Irregularly arranged cells

  • Multinucleated giant cells


Slide34 l.jpg

Pleomorphic Sarcoma


Lipoma l.jpg

Lipoma

  • Benign, well-circumscribed tumor of

    well-differentiated adipocytes

  • In adult, upper back, neck, shoulder

  • Usually subcutaneous, any site of

    adipose tissue

  • Most common type of benign soft

    tissue tumor

  • Resemble normal adipose tissue

  • Subtypes:angiolipoma, spindle cell lipoma


Slide36 l.jpg

Lipoma


Liposarcoma l.jpg

Liposarcoma

  • Second most common sarcoma in adults

  • In deep compartments of extremities

    & retroperitoneum

  • Lipoblasts

  • Several subtypes

- Well differentiated/atypical lipoma

- Myxoid / Round cell

- Pleomorphic


Slide38 l.jpg

Liposarcoma


Hemangioma l.jpg

Hemangioma

  • Benign lesion

  • Resemble normal blood vessels

  • Congenital or non-congenital

  • Most common in infants & children

  • Head & neck, internal organs - liver


Angiosarcoma l.jpg

Angiosarcoma

  • Malignant vascular tumor

  • Many locations: skin, soft tissue,

    breast, live, spleen

  • Irregular channels & atypical

    endothelial cells

  • CD31- endothelial cell marker


Slide42 l.jpg

Angiosarcoma


Schwannoma l.jpg

Schwannoma

  • Benign tumor of neural differentiation

    - Schwann cells

  • In association with large nerve trunks

  • Head & neck, extremities

  • Antoni A

  • Antoni B

-- Cellular area, palisaded nuclei

  • -- Less cellular area, myxoid background

  • S-100


Slide44 l.jpg

Schwannoma


Synovial sarcoma l.jpg

Synovial sarcoma

  • Malignant soft tissue tumor

  • Unknown origin- misnomer

  • Arising in region of a joint

    & other sites of deep soft tissue

  • Multilobular

  • Biphasic pattern

    - spindle cells

    - epithelial - like cells

  • t( X;18 )


Slide46 l.jpg

Synovial sarcoma


  • Login