Difference between revisions of "Small round cell tumours"

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Small round cell tumours (view source)

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[[Image:Ewing sarcoma - very high mag.jpg|thumb|right|[[Micrograph]] showing a small round cell tumour ([[Ewing sarcoma]]) in the lung. [[H&E stain]].]]
'''Small round cell tumours''' (SRCT), also '''small round blue cell tumours''' (SRBCT), are a group of tumours that have a similar histologic appearance.   
'''Small round cell tumours''' (SRCT), also '''small round blue cell tumours''' (SRBCT), are a group of tumours that have a similar histologic appearance.   


==General==
==General==
It is a group of tumours that is seen more often in childhood than adulthood.
*Group of tumours that is typically seen in childhood and younger adults.
*Most common small round cell tumour is non-Hodgkin lymphoma.<ref name=pmid23998069/>


===A short DDx of small round cell tumours===  
===A short differential diagnosis of small round cell tumours===  
A short DDx of SRCTs:<ref>URL: [http://www.thedoctorsdoctor.com/diseases/small_round_blue_cell_tumor.htm http://www.thedoctorsdoctor.com/diseases/small_round_blue_cell_tumor.htm]. Accessed on: 2 July 2010.</ref><ref>{{cite journal |author=Chen QR, Vansant G, Oades K, ''et al.'' |title=Diagnosis of the small round blue cell tumors using multiplex polymerase chain reaction |journal=J Mol Diagn |volume=9 |issue=1 |pages=80–8 |year=2007 |month=February |pmid=17251339 |pmc=1867426 |doi=10.2353/jmoldx.2007.060111 |url=}}</ref>
A short DDx of SRCTs:<ref>URL: [http://www.thedoctorsdoctor.com/diseases/small_round_blue_cell_tumor.htm http://www.thedoctorsdoctor.com/diseases/small_round_blue_cell_tumor.htm]. Accessed on: 2 July 2010.</ref><ref>{{cite journal |author=Chen QR, Vansant G, Oades K, ''et al.'' |title=Diagnosis of the small round blue cell tumors using multiplex polymerase chain reaction |journal=J Mol Diagn |volume=9 |issue=1 |pages=80–8 |year=2007 |month=February |pmid=17251339 |pmc=1867426 |doi=10.2353/jmoldx.2007.060111 |url=}}</ref>
*[[Neuroblastoma]].
*[[Neuroblastoma]].
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Memory device: 4 -blastomas (hepato-, neuro-, nephro-, retino-), PNET/Ewing sarcoma (medulloblastoma), LADSSS (lymphoma, alveolar rhabdomyosarcoma, DSRCT, small cell carcinoma, small cell osteosarcoma, synovial sarcoma).
Memory device: 4 -blastomas (hepato-, neuro-, nephro-, retino-), PNET/Ewing sarcoma (medulloblastoma), LADSSS (lymphoma, alveolar rhabdomyosarcoma, DSRCT, small cell carcinoma, small cell osteosarcoma, synovial sarcoma).


 
===A long differential diagnosis of small blue cell tumours===
===A long DDx of small blue cell tumours===
Adapted from ''Miller'' with modifications:<ref name=miller>Miller RT. (Sep 2013). ''Atlantic Diagnostic Immunohistochemistry Symposium''. St. John's, NL, Canada.</ref>
{| class="wikitable sortable"
{| class="wikitable sortable"
! Tumour
! Tumour
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! Notes/comments
! Notes/comments
|-
|-
| [[Melanoma]]  
| [[Malignant melanoma]], small cell
| melanoma  
| melanoma  
|   
|   
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|   
|   
|-
|-
| [[Islet cell tumour / carcinoid]]  
| [[Islet cell tumour]] ([[carcinoid]])
| carcinoma  
| carcinoma  
|   
|   
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|   
|   
|-
|-
| [[Desmoplastic small cell tumour]]  
| [[Desmoplastic small round cell tumour]]  
| sarcoma  
| sarcoma  
|   
|   
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|   
|   
|-
|-
| [[Papillary-cystic tumor of pancreas]]  
| [[Papillary-cystic tumour of pancreas]]  
| other  
| other  
|   
|   
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|   
|   
|-
|-
| [[Wilm's tumour]]  
| [[Wilms tumour]]  
| other  
| other  
|   
|   
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| [[Small cell mesothelioma]]  
| [[Small cell mesothelioma]]  
| carcinoma  
| carcinoma  
|   
| <ref name=pmid1310669>{{Cite journal | last1 = Mayall | first1 = FG. | last2 = Gibbs | first2 = AR. | title = The histology and immunohistochemistry of small cell mesothelioma. | journal = Histopathology | volume = 20 | issue = 1 | pages = 47-51 | month = Jan | year = 1992 | doi =  | PMID = 1310669 }}</ref>
|-
|-
| [[Pulmonary blastoma]]  
| [[Pulmonary blastoma]]  
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| degenerative cases  
| degenerative cases  
|-
|-
| [[Granulosa cell tumors]]  
| [[Granulosa cell tumour]]  
| sex cord tumour  
| sex cord tumour  
|   
|   
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|-
|-
| [[Small cell osteosarcoma]]  
| [[Small cell osteosarcoma]]  
| Chondro-osseous tumours  
| chondro-osseous tumours  
|   
|   
|-
|-
| [[Mesenchymal chondrosarcoma]]  
| [[Mesenchymal chondrosarcoma]]  
| Chondro-osseous tumours  
| chondro-osseous tumours  
|   
|   
|-
|-
| [[Myxoid chondrosarc]]  
| [[Myxoid chondrosarcoma]]  
| Chondro-osseous tumours  
| chondro-osseous tumours  
|   
|   
|-
|-
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|   
|   
|-
|-
| [[Glomus tumor]]  
| [[Glomus tumour]]  
| other  
| other  
|   
|   
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|   
|   
|-
|-
| [[Small cell angiosarcoma]]  
| [[angiosarcoma|Small cell angiosarcoma]]  
| vascular lesions  
| vascular lesions  
|   
|   
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|-
|-
|}
|}
Notes:
#This [[DDx]] includes small cells that may be spindled.
#The DDx for large (non-pleomorphic) epithelioid cells is found in ''[[large epithelioid tumours]]''.


==Microscopic==
==Microscopic==
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| nests, thin fibrovascular septae, lymphocytes, ganglion-like cells (prominent nucleolus), neuropil (eosinophilic, fluffy, finely vacuolated)
| nests, thin fibrovascular septae, lymphocytes, ganglion-like cells (prominent nucleolus), neuropil (eosinophilic, fluffy, finely vacuolated)
| adrenal gland, sympathetic chain; usu. < 3 years old
| adrenal gland, sympathetic chain; usu. < 3 years old
| NB-84+, NSE+, S100-
| NB-84+, NSE+, [[S-100]]-
|-
|-
| [[Nephroblastoma]] (Wilms tumour)
| [[Nephroblastoma]] (Wilms tumour)
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| '''nests with "jigsaw" border'''  
| '''nests with "jigsaw" border'''  
| peritoneum (abdomen or plevis); male > female; locally invasive
| peritoneum (abdomen or plevis); male > female; locally invasive
| keratin+, EMA+, desmin+ !!!
| [[keratin]]+, [[EMA]]+, desmin+ !!!
|-
|-
| [[Small cell carcinoma]]
| [[Small cell carcinoma]]
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| '''dyscohesive cells''', usu. ~2x normal (resting) lymphocyte, usu. nucleolus
| '''dyscohesive cells''', usu. ~2x normal (resting) lymphocyte, usu. nucleolus
| usu. lymphadenopathy
| usu. lymphadenopathy
| CD45, CD20, TdT, CD3
| CD45, [[CD20]], TdT, [[CD3]]
|-
|-
|}
|}
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| -ve
| -ve
|}
|}
More general panel:<ref name=pmid23998069>{{Cite journal  | last1 = D'cruze | first1 = L. | last2 = Dutta | first2 = R. | last3 = Rao | first3 = S. | last4 = R | first4 = A. | last5 = Varadarajan | first5 = S. | last6 = Kuruvilla | first6 = S. | title = The role of immunohistochemistry in the analysis of the spectrum of small round cell tumours at a tertiary care centre. | journal = J Clin Diagn Res | volume = 7 | issue = 7 | pages = 1377-82 | month = Jul | year = 2013 | doi = 10.7860/JCDR/2013/5127.3132 | PMID = 23998069 }}</ref>
*CD45, CD20, CD3, CD99, desmin, EMA, pankeratin, synaptophysin, chromogranin, GFAP.


==See also==
==See also==
*[[Soft tissue lesions]].
*[[Soft tissue lesions]].
*[[Basics]].
*[[Large epithelioid tumours]].
*[[Pleomorphic tumours]].


==References==
==References==
Michael
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