Soft tissue tumor

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Revision as of 16:58, 9 December 2022 by Mikael Häggström (talk | contribs) (→‎Evaluation: Consultation)
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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 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.

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References


Image sources