into the roots: Soft tissue neoplasms

Thursday, February 9, 2012

Soft tissue neoplasms

Angiolymphoid hyperplasia with eosinophilia

A skin lesion consisting of capillaries surrounded by endothelial cells, lymphocytes and diagnostically, eosinophils.

Originally though to be epithelioid hemangioma, it is now known to be a reactive process.

Next, a cyst like lesion in outer canthus of right eye. The location being typical, and the insular morphology being present, the only thing needed now

is pallisading

which leads to Basal cell carcinoma, keratinising.

Dedifferentiated liposarcoma

A soft tissue lesion showing mature fat cells and surprisingly, rhabdomyoblasts

on more sections, even spindle cells and osteoid

Thus a dedifferentiated liposarcoma (anybody suggest a better name).

Well differeniated liposarcoma

A more conventional, 'well differentiated liposarcoma' is this one

Dermatofibrosarcoma protuberans

This one is showing cotton flower or storiform apperance on low power,

and high power confirms the spindly apperance

I searched for melanin (for a Bednar tumor) with no luck.

Glomus tumor

A vascular tumor made of perfectly round cells arising in terminal phalanx.

Probably arising from the glomus body, which is an AV shunt at terminals.

Granular cell tumor

Next, a skin lesion showing a Zell Ballen pattern, but with very much round nuclei

Malignant fibrous hisiocytoma

We have arrived at the wastebasket of soft tissue tumors, which is a malignant fibrous histiocytoma. This one needs no explanation.

Malignant peripheral nerve sheath tumor

showing buckled nuclei among many spindle cells

possibly malignant peripheral nerve sheath tumor. Need S100 to confirm.

Schwannoma

Another one with classic Antoni A and B areas, Verocay bodies. A Schwannoma.

Alveolar soft part sarcoma

Fibrous hamartoma of infancy

One from the 'infantile fibrous lesions' group - fibrous hamartoma of infancy. Look at the undifferentiated mesenchyme, stellate cells contained within the fibrous septa