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MM1 Leesy > B6.016 - Soft Tissue Tumors Prework Part 2 > Flashcards

B6.016 - Soft Tissue Tumors Prework Part 2 Flashcards

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1
Q

vascular tumors

A

hemangioma

kaposi sarcoma

angiosarcoma

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2
Q

what are hemangiomas

A

majority are superficial lesions, often head and neck, may occur internally especially the liver

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3
Q

types of hemangiomas

A

capillary hemangioma

pyogenic granuloma (lobular capillary hemangioma)

cavernouse hemangioma

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4
Q
A

capillary hemangioma

closely packed aggregates of thin walled capillaries

juvenile hemangiomas of the skin of newborns is extremely common

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5
Q
A

cavernous hemangioma

larger, more frequently involve deep structures like liver

histo: large cavernous vasvcular spaces filled with blood

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6
Q
A

capillary hemangioma

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7
Q
A

capillary hemangioma

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8
Q
A

cavernous hemangioma

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9
Q
A

pyogenic granuloma (lobular capillary hemangioma)

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10
Q

kaposi sarcoma feautures

A

HHV8 associated

low to intermediate grade sarcoma, locally aggressive

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11
Q

what are the 4 forms of KS

A

classic or european

african/endemic

transplant associated

AIDS associated

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12
Q

describe classic/european KS

A

chronic, indolent coures of older men, skin lesions, not associated with HIV

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13
Q

describe african/endemic KS

A

protracted, progressive coures, lymphadenopathy, not associated with HIV

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14
Q

describe transplant associated KS

A

aggressive coures, involves LN, mucosa and internal organs, may resolve after withdrawal of immunosuppression

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15
Q

describe AIDS associated KS

A

HIV-1 most aggressive form, most common AIDs associated cancer of US

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16
Q

pathogenesis of KS

A

regardless of clinical subtype 95% of KS are infected iwth HHV8, aka KSHV

KSHV can be trnasmitted sexually as well as by poorly understood nonsexual routes

KSHV is a necessary requirement for KS development but tumor progression also requires a cofactor like HIV

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17
Q

histology of KS and 3 stages/clinical coures

A

patches

plaques

nodules

proliferation of slit like vascular channels, lined by plump spindle cells with extravasated RBCs

frequent mitoses

clinically variable

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18
Q
A

KS

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19
Q
A

KS

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20
Q
A

KS

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21
Q

feaures of angiosarcoma

A

more often in older adults

most commonly involves skin, soft tissue, breast and liver

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22
Q

what is hepatic angiosarcoma associated with

A

hepatic angiosarcoma: associated with chemical carcinogens (arsenic, thorotrast, polyvinyl chlloride PVC)

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23
Q

what is upper extremity angiosarcoma associated with

A

lymphedema following axillary lymph node dissection in radical mastectomy for breast cancer

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24
Q

what can angiosarcoma be associated with

A

radiation (post radiation angiosarcoma)

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25
angiosarcoma
26
angiosarcoma
27
histo and prognosis of angiosarcoma
histo: vascular channels lined by atypical plump malignant endothelial cells **IHC: CD31+** Prognosos: poor outcome with frequent local recurrence and distant metastasis
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angiosarcoma
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angiosarcoma
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angiosarcoma
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angiosarcoma
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angiosarcoma
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angiosarcoma
34
benign nerve sheath tumors
schwannoma neurofribroma
35
malingnant nerve sheath tumors
malignant peripheral nerve sheath tumor
36
shwannoma features
encapsulated benign nerve sheath tumor composed of schwann cells; age 20-40 eccentric mass loosly attached to a nerve usually 90% sporadic; 3-10% associated with **NF2** excision curative
37
histo and IHC of shwannoma
histo: spindle cells show nuclear palisading, Antoni A and Antoni B areas ## Footnote **IHC: S100 positive in all cells**
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Schwannoma
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schannoma
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schannoma
41
neurofibroma features
non encapsulated benign nerve sheath tumor composed of admixture of axons, schwann cells, perineural cells and fibroblasts Most (90%) are sporadic, 10% occur in NF1 and may be solitary multiple large or plexiform tumors
42
histo and IHC of neurofibroma
histo: bundles of spindle cells with angulated, elongated nuclei and wavy cell process in a loose myxoid and collagenous background IHC: S100 positive in scattered cells
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neurofibroma
44
neurofibroma
45
plexiform neurofibroma NF1
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plexiform neurofibroma NF1
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plexiform neurofibroma NF1
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plexiform neurofibroma
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plexiform neurofibroma
50
feautres of malignant peripheral nerve sheath tumor
sarcoma arising from a nerve or from a benign nerve sheath tumor or showing nerve sheath differentiation 50% sporadic 50% associated with NF1 adults 20-50 70% arise in major nerve trunks local recurrence \>40%, metastasis 30-60%
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MPNST
52
histo, IHC of MPNST
histo: spindle and epitheliod cell variants IHC: foal S100 in 60% 15% may be mixed with other sarcoma types (heterologous elements) - rhabdomyosarcoma (triton tumor) - cartilage or bone - angiosarcoma, glandular elements
53
MPNST
54
MPNST
55
MPNST with heterologous elements (chondro)
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MPNST with heterologous elements (rhabdo/triton)
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tumors of uncertain histogenesis
synovial sarcoma
58
features of synovial sarcoma
cell of origin unclear most occur in pts 20-40 yrs most occur in deep soft tissue around large joints of extremities, mainly knees
59
histo/features of synovial sarcoma and tx
histo: biphasic tumor with both epithelial and mesenchymal (sarcomatous) components mesenchymal component may predominate characteristic chromosomal transloacation (t(x;18)) treated with wide excision and chemo commonly metastasizes to lung, bone, regional LN
60
synovial sarcoma
61
synovial sarcoma
62
synovial sarcoma
63
synovial sarcoma epithelial marker
64
synovial sarcoma mesenchymal marker
65
describe UPS
undifferentiated pleomorphic sarcoma previously called MFH odler adults proximal extremities and retroperitoneum usually large grey-white unencapsulated mass in muscle
66
UPS histo
no differentiation toward specific tissue type malignant spindle cells in storiform pattern, large bizarre mulitnucleated pleomorphic cells aggressive, may recur metastasize
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UPS
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UPS
69
UPS

MM1 Leesy (6 decks)

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