Difference between revisions of "Soft tissue tumor"

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[[File:Histopathology of solitary fibrous tumor.png|thumb|A '''solitary fibrous tumor''', an example of spindle cell tumor.]]
 
[[File:Histopathology of solitary fibrous tumor.png|thumb|A '''solitary fibrous tumor''', an example of spindle cell tumor.]]
 
In case of '''spindle cell tumors''' (having elongated nuclei), the following features may help to roughly classify the tumor:
 
In case of '''spindle cell tumors''' (having elongated nuclei), the following features may help to roughly classify the tumor:
*Pointed on both ends: True fibroblastic tumors
+
*Pointed on both ends: '''True fibroblastic tumors'''
*Pointed on one end and blunted on the other ("bullet-shaped"): Neural
+
*Pointed on one end and blunted on the other ("bullet-shaped"): '''Neural'''/'''nerve sheath''' tumors (see section below)
 
*Blunted on both ends ("cigar-shaped"): '''[[Smooth muscle tumor]]'''
 
*Blunted on both ends ("cigar-shaped"): '''[[Smooth muscle tumor]]'''
 
*Triangular: Myofibroblastic
 
*Triangular: Myofibroblastic
 
In uncertain cases, the following [[immunohistochemistry]] markers are usually helpful:
 
In uncertain cases, the following [[immunohistochemistry]] markers are usually helpful:
 
*'''CD34''', indicating a solitary fibrous tumor
 
*'''CD34''', indicating a solitary fibrous tumor
*'''S100''', indicating a neural tumor
+
*'''S100''', indicating a neural or nerve sheath tumor (see section below)
 
*'''Desmin''', indicating a muscular tumor (skeletal muscle or '''[[Smooth muscle tumor]]''')
 
*'''Desmin''', indicating a muscular tumor (skeletal muscle or '''[[Smooth muscle tumor]]''')
 
*'''Beta catenin''', indicating fibromatosis
 
*'''Beta catenin''', indicating fibromatosis
 +
Also consider a '''sarcoma''' as a differential diagnosis, and if unsure, have a low threshold for '''[[Consultation|consulting]]''' with people with expertise in the matter, as the visual difference between benign and malignant spindle cells is relatively subtle.
 +
 +
===Neural or nerve sheath tumors===
 +
<gallery mode=packed heights=210px>
 +
File:Schwannoma with Antoni A and Antoni B areas.jpg|'''Schwannoma''', characterized by cellular Antoni A areas (top) and a loose paucicellular Antoni B areas (bottom).
 +
File:Antoni A area of schwannoma with Verocay bodies - annotated.png|'''Schwannoma''' is also characterized by Verocay bodies (one encircled), which are stripes of anuclear zones, separated by cellular palisades.
 +
File:Histopathology of neurofibroma.jpg|'''Neurofibroma''': A spindle cell lesion composed of slender fibroblast-like cells with storiform pattern and very low amount of stroma.
 +
</gallery>
 
{{Further|Evaluation of suspected malignancies}}
 
{{Further|Evaluation of suspected malignancies}}
 
{{Bottom}}
 
{{Bottom}}

Revision as of 15:43, 10 December 2022

Author: Mikael Häggström [note 1]

Gross processing

Generally sample one slice per centimeter.

Evaluation

A solitary fibrous tumor, an example of spindle cell tumor.

In case of spindle cell tumors (having elongated nuclei), the following features may help to roughly classify the tumor:

  • Pointed on both ends: True fibroblastic tumors
  • Pointed on one end and blunted on the other ("bullet-shaped"): Neural/nerve sheath tumors (see section below)
  • Blunted on both ends ("cigar-shaped"): Smooth muscle tumor
  • Triangular: Myofibroblastic

In uncertain cases, the following immunohistochemistry markers are usually helpful:

  • CD34, indicating a solitary fibrous tumor
  • S100, indicating a neural or nerve sheath tumor (see section below)
  • Desmin, indicating a muscular tumor (skeletal muscle or Smooth muscle tumor)
  • Beta catenin, indicating fibromatosis

Also consider a sarcoma as a differential diagnosis, and if unsure, have a low threshold for consulting with people with expertise in the matter, as the visual difference between benign and malignant spindle cells is relatively subtle.

Neural or nerve sheath tumors

Further information: Evaluation of suspected malignancies

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References


Image sources