Soft Tissue Tumors (Dumbledorf) Flashcards
fatty tumors
lipoma/liposarcoma
fibrous tumors
reactive proliferans/fibromatosies/fibrosarcoma
fibrohistiocytic tumors
benign and malignant histiocytoma
dematofibroscarcoma protuberans
smooth muscle tumors
leiomyoma/leiomyosarcoma
as mesenchymal proliferations that occur in the extraskeletal, nonepithelialized tissues of the body, excluding the viscera, coverings of the brain, and the lymphoreticular system
definition of soft tissue tumors
a connective tissue neoplasm, usually highly malignant, formed by proliferation of mesodermal cells
sarcoma
rapidly growing, small, benign, fibrous proliferation on the subcutis, usually encountered as a small mass
nodular fascitis
epidemiology of nodular fascitis
young adult
*sometime after trauma
Where on the body is nodular fasciitis most commonly seen?
arms
**particularly the flexor aspects of the forarms**
What is the key feature that distinguishes myositis ossificans from a malignancy?
MATURE, woven bone is well formed at peripher BUT there is IMMATURUE bone at the center
**malignancies lack a maturation pattern **
What are these? What is the major difference?
top : liposarcoma (malignant)
bottom: lipoma (benign)
Nodular Fasciitis
(rapidly growing, small, benign, fibrous proliferation on the subcutis)
fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended, ring finger and pinky finger are most commonly affected
Dupuytren contracture
(type fo superficial fibromatosis)
Where do superficial fibromatoses commonly arise?
hand, feet, penis
Peyronie disease
penile fibromatoses
Ledderhose disease
plantar fibromatoses
**younger pts and often bilateral
Dupuytren contractures
palmar fibromatoses
**usually presents bilaterally
arise in the digits of infants and young children and are characterized by peculiar inclusion-like condensations of cytoplasmic actin.
infantile digital fibromatoses
myositis ossificans
Mature, woven bone at periphery (right) and Immature bone at center (left)
lipoblast
in liposarcoma
“tissue culture” appearence
nodular fascitis (histo)
woven bone in granulation tissue
reactive proliferans: myositis ossificans
What is going on in the plam of a hand with a Dupuytren contracture (i.e. what is making the hand look funny?)
- the tissues under the skin on the palm of the hand thicken and shorten so that the tendons connected to the fingers cannot move freely
- The palmar aponeurosis becomes hyperplastic and undergoes contracture
epidemiology of Dupuytren contracture
Incidence increases after the age of 40; at this age men are affected more often than women. After the age of 80 the distribution is about even.
deep fibromatosis
Where a deep fibromatoses typically found in and what is the sex predominance…
- pediatic pts
- pts in late 20s
- adult years
- extra abdominal and female
- abdominal wall and female
- extra abdominal and no sex predominance
a tumor of mesenchymal cell origin that is composed of malignant fibroblasts in a collagen background
fibrosarcoma
fibrosarcomas of bone are (painless or painful)
painful
fibrosarcomas are a (soft tissue mass or bone tumor)
BOTH
Where do fibrosarcomas of bone typically form?
lowe extremities, esp femur and tibia
(also, metaphysis of long bones and in the pelvis)
epidemiology of fibrosarcoma of bone
Men > women
can occur @ any age but most commonly in 30s
Where do fibrosarcoma of soft tissue usually arise?
thigh and posterior knee
Fibrosarcomas of soft tissue are (painless or painful)
painless
fibrosarcoma of soft tissue is generally found (superfical or deep) to the fascia
deep
non-cancerous growth of dermal dendritic histiocytic cells
dermatofibroma (aka fibrous histiocytoma)
Where do dermatofibromas most commonly arise?
arms and legs
Why will a dimple form in the skin over a dermatofibroma when it is squeezed?
the skin is attatched to the underying fibrous tissue
What layers of the skin does a dermatofibrosarcoma protuberans affect?
arises in dermis and invades deeper subcutaneous tissue (fat, fascia, muscle, bone)
cellular origin of dermatofibrosarcoma protuberans
fibroblastic, histocytic, or neuralectodermal
OR pluripotential progenitor cells, such as undifferentiated mesenchymal cells
fibroblastlike and histiocytelike cells in varying proportions, with spindled and rounded cells exhibiting a storiform arrangement.
malignant fibrous histocytoma
What is the most significant prognostic factor for a malignant fibrous histiocytoma?
stage (defined by grade, size, and +/- mets)
Where do malignat fibrous histiocytoma commonly metastazise to?
lungs (90%), bone (8%), liver (1%)
“fish flesh” appearance.
rhabdomyosarcoma
“storiform” (woven mat) pattern
malignat fibrous histocytoma
Reactive bone formation in muscle as a result of injury, usually blunt trauma
reactive proliferants: myositis ossificans
What cells make up a rhabdomyosarcoma?
rhabdomyoblasts
What are the most common site for a rhabdomyosarcoma to arise?
- adjacent to the base of the skull (parameningeal)
- around the eye
- nose and throat
- arms and lefs
- GU
sooooo, pretty much anywhere
most common place to find leiomyoma
uterus
(smooth muscle tumor)
Uterine leiomyoma are..
symptomatic, asymptomatic
regress or progress after menopause
estrogen sensitive or insensitive
asymptomatic
regress
estrogen senstivie (why they prob regress after menopause)
leimyoma affect ____% of reproductve age women
25-40%
that shit be cray
Leiomyosarcoma can arise anywhere in the body, but is more common in the …
uterus, abdomen, or pelvis
sarcomas spread via (blood stream or lymphaics)
blood stream
Where do leiomyosarcomas typically metastasize to?
lungs
elongated “strap” cells
Rhabdomyosarcoma
bland histiocytic type cells interdigitate between normal collagen bundles
Dermatofibroma (fibrous histiocytoma)
**not as structured/organized a malignant fibrous tumor
cigar shaped nuclei
Leiomyoma or leiomyosarcoma
arises at the site of a minor injury, especially an insect bite or thorn prick
Dermatofibroma (fibrous histiocytoma)
locally aggressive fibrous tumor with a high recurrence rate;
Dermatofibrosarcoma protuberans
Can get large enough that they outgrow their blood supply and may undergo areas of necrosis with ultimate formation of one or more cysts
Leiomyoma or leiomyosarcoma
dermatofibroma
leiomyosarcoma
with partially hemorrhagic necrosis
fibrosarcoma
“herringbone” pattern
dermatofibrosarcoma protruberans
shows greater cellularity than dermatofibroma with greater cellular atypia, though without mitotic figures or necrosis.
dermatofibroma
higher power = bland histiocytic type cells interdigitate between normal collagen bundles
fibrosarcoma
herringbone pattern
malignant fibrous histiocytoma
typical bizzare, giant cells
mailignant fibrous histocytoma
“storiform” pattern
dermatofibrosarcoma protuberans
rhabdomyosarcoma
rhabdomyosarcoma with an elongated “strap” cell
rhabdomyosarcoma
lots of pink cytoplasm
leiomyoma with a cyst (arrow) bc it out grew its blood supply
leiomyosarcoma with cigar shaped nuclei (which are seen in leiomyomas too)
leiomyoma with cigar shaped cell
f
fibrosarcoma
herringbne pattern
