Musculo-skeletal soft tissue tumours Flashcards
what do soft tissue tumours often present as
a lump or swelling
what may soft tumours be associated with
pain or discomfort
are superficial lesions more or less likely to be malignant
less likely
what is a ganglion cyst
a lump found near a joint capsule or tendon sheath
what part of the body do ganglion cysts often arise
the wrist
what changes are seen in a ganglion cyst
degenerative change within the connective tissue and secondary inflammatory changes
what is seen histologically in ganglion cysts
a space with myxoid material
is a ganglion a true cyst, and why/why not
no not a true cyst because it has no epithelial lining
describe the pathology seen with nodular fasciitis
cellular proliferation of fibroblastic and myofibroblastic cells
what are some properties of nodular fasciitis
self limiting disorder and a rapidly growing tumour
what group of people is nodular factiitis usually seen in
young adults, history of trauma in 25% cases
what histological changes are seen in nodular fasciitis
stellate + spindle tissue culture appearance, haemorrhage, mitosis and increased plump cells
what other tumour is similar to nodular fasciitis
myositis ossificans
what is there usually a history of in myositis ossificans
trauma
what is myositis ossificans associated with
insertions of large muscles of arms and legs
what pathology is seen with myositis ossificans
cellular proliferation but with evidence of bone formation and zonation
(recognition of organisation is critical)
what group of people is superficial fibromatoses most commonly seen in
men > women, average age 60
common
what condition is superficial fibromatoses associated with
Dupuytren’s
describe the cause of superficial fibromatoses
idiopathic
associated with alcohol, diabetes and anticonvulsants
describe the pathology seen in Dupuytren’s
firm grey-white tissue, nodules + fascicles, bland fibroblasts, dense collagen
describe deep fibromatoses
desmoid tumour, large infiltrative masses that do not metastasise
what group of people is deep fibromatoses often seen in
often young adults, teen to 30s
what sites does deep fibromatoses involve
musculo-aponeurotic tissue of abdominal wall, mesenteric tissue, limb girdles
what are the 2 different types of tenosynovitis
giant cell tumour of tendon sheath and pigmented villonodular synovitis
(similar histology)
what parts of the body does giant cell tumour of the tendon sheath involve
the digits and wrist
what joints does pigmented villonodular synovitis affect
large joints
what pathology is seen with giant cell tumour of tendon sheath
reactive proliferation
describe the recurrence of the different types of tenosynovitis
giant cell tumour of tendon sheath = excise, rarely recurs
pigmented villonodular synovitis = more likely to recurt
what is the nomenclature of benign and malignant soft tissue tumours
benign = oma malignant = sarcoma
what are the grading features of sarcomas
degree of differentiation, degree of proliferation(mitotic count), presence of coagulative necrosis
