Difference between revisions of "Epithelioid cell lesions"

From Libre Pathology
Jump to navigation Jump to search
(merge in ''Large epithelioid tumours'')
(+image of epithelioid lesion)
 
(5 intermediate revisions by the same user not shown)
Line 1: Line 1:
'''Epithelioid cell lesions''' are very common in pathology. Malignant epithelioid lesions are usually a carcinoma.
[[Image:Epithelioid sarcoma - cropped - very high mag.jpg|thumb|right|250px|An tumour with an epithelioid morphology ([[epithelioid sarcoma]]). [[H&E stain]].]]
'''Epithelioid cell lesions''' are very common in pathology. Malignant epithelioid lesions are most often carcinomas... but may be a large number different tumours.


==Differential diagnosis==
==Classification==
===A short DDx===
Broadly, epithelioid lesions are split into:
*[[Small round cell tumours]].
*[[Large epithelioid tumours]].
 
==General differential diagnosis==
A short DDx:
*Carcinoma (primary and metastatic).
*Carcinoma (primary and metastatic).
*[[Malignant melanoma]].
*[[Malignant melanoma]].
*Sarcoma.
*Sarcoma.


====Epithelioid sarcomas====
===Epithelioid sarcomas===
All rules are made to be broken... some epithelioid lesions are sarcomas:<ref name=pmid19664495>{{cite journal |author=Dei Tos AP, Wagner AJ, Modena P, Comandone A, Leyvraz S |title=Epithelioid soft tissue tumors |journal=Semin. Oncol. |volume=36 |issue=4 |pages=347–57 |year=2009 |month=August |pmid=19664495 |doi=10.1053/j.seminoncol.2009.06.005 |url=}}</ref>
All rules are made to be broken... some epithelioid lesions are sarcomas:<ref name=pmid19664495>{{cite journal |author=Dei Tos AP, Wagner AJ, Modena P, Comandone A, Leyvraz S |title=Epithelioid soft tissue tumors |journal=Semin. Oncol. |volume=36 |issue=4 |pages=347–57 |year=2009 |month=August |pmid=19664495 |doi=10.1053/j.seminoncol.2009.06.005 |url=}}</ref>
*[[Epithelioid sarcoma]].
*[[Epithelioid sarcoma]].
Line 21: Line 27:


Note:
Note:
*A more complete list is below.
*An exhaustive [[DDx]] is found in ''[[large epithelioid tumours]]'' and ''[[small round cell tumours]]''.
 
===Large epithelioid tumours===
The following is an exhaustive [[DDx]] for a ''large epithelioid tumour''.
 
{| class="wikitable sortable"
! Tumour
! Group
! Notes/comments
|-
| [[Melanoma]]
| Miscellaneous
| 
|-
| [[PEComa]]
| Miscellaneous
| esp. [[epithelioid angiomyolipoma]]
|-
| [[Perivascular epithelioid cell sarcoma]]
| Miscellaneous
| type of PEComa, looks like clear cell carcinoma<ref name=pmid11406657>{{Cite journal | last1 = Bonetti| first1 = F.| last2 = Martignoni| first2 = G.| last3 = Colato| first3 = C.| last4 = Manfrin| first4 = E.| last5 = Gambacorta| first5 = M.| last6 = Faleri| first6 = M.| last7 = Bacchi| first7 = C.| last8 = Sin| first8 = VC.| last9 = Wong| first9 = NL.| title = Abdominopelvic sarcoma of perivascular epithelioid cells. Report of four cases in young women, one with tuberous sclerosis.| journal = Mod Pathol| volume = 14| issue = 6| pages = 563-8| month = Jun| year = 2001| doi = 10.1038/modpathol.3880351| PMID = 11406657 }}</ref>
|-
| [[Paraganglioma-like dermal melanocytic tumour]]
| Miscellaneous
| <ref name=pmid15577676>{{Cite journal | last1 = Deyrup| first1 = AT.| last2 = Althof| first2 = P.| last3 = Zhou| first3 = M.| last4 = Morgan| first4 = M.| last5 = Solomon| first5 = AR.| last6 = Bridge| first6 = JA.| last7 = Weiss| first7 = SW.| title = Paraganglioma-like dermal melanocytic tumor: a unique entity distinct from cellular blue nevus, clear cell sarcoma, and cutaneous melanoma.| journal = Am J Surg Pathol| volume = 28| issue = 12| pages = 1579-86| month = Dec| year = 2004| doi = | PMID = 15577676 }}</ref>
|-
| [[Carcinoma]]
| Epithelial tumours
|HCC and adrenal cortical carcinoma, often AE1/AE3 -ve
|-
| [[Hepatoid Adenocarcinoma]]
| Epithelial tumours
| 
|-
| [[Malignant mixed Muellerian tumour]]
| Epithelial tumours  
| 
|-
| [[Myoepithelial carcinoma]]  
| Epithelial tumours
| 
|-
| [[Myoepithelioma of soft tissue]]
| Epithelial tumours
| may mimic [[extraskeletal myxoid chondrosarcoma]] or proximal variant of [[epithelial sarcoma]]
|-
| [[Acinar cell carcinoma]]
| Epithelial tumours
| 
|-
| [[Neuroendocrine carcinoma]]
| Epithelial tumours
| may have a rhabdoid morphology<ref name=pmid12717248>{{Cite journal | last1 = Perez-Montiel| first1 = MD.| last2 = Frankel| first2 = WL.| last3 = Suster| first3 = S.| title = Neuroendocrine carcinomas of the pancreas with 'Rhabdoid' features.| journal = Am J Surg Pathol| volume = 27| issue = 5| pages = 642-9| month = May| year = 2003| doi = | PMID = 12717248 }}</ref>
|-
| [[Medullary thyroid carcinoma]]
| Epithelial tumours
| 
|-
| [[Thymoma]]
| Epithelial tumours
| 
|-
| [[Cutaneous myoepithelioma]]
| Epithelial tumours
| <ref name=pmid11224605>{{Cite journal | last1 = Kutzner| first1 = H.| last2 = Mentzel| first2 = T.| last3 = Kaddu| first3 = S.| last4 = Soares| first4 = LM.| last5 = Sangueza| first5 = OP.| last6 = Requena| first6 = L.| title = Cutaneous myoepithelioma: an under-recognized cutaneous neoplasm composed of myoepithelial cells.| journal = Am J Surg Pathol| volume = 25| issue = 3| pages = 348-55| month = Mar| year = 2001| doi = | PMID = 11224605 }}</ref>
|-
| Cutaneous adnexal tumours ([[spiradenoma]], [[acrospiroma]])
| Epithelial tumours
| 
|-
| [[Hyaline-rich chondroid syringoma]]
| Epithelial tumours
| 
|-
| [[Hurthle cell tumour]]
| Epithelial tumours
| 
|-
| [[Mesothelioma]]
| Epithelial tumours
| "lymphohistiocytoid" variant
|-
| [[Seminoma]]
| Germ- cell / Sex-Cord Stromal
| 
|-
| [[Embryonal carcinoma]]
| Germ- cell / Sex-Cord Stromal
| 
|-
| [[Yolk sac tumour]]
| Germ- cell / Sex-Cord Stromal
| consider hepatoid variant
|-
| [[Choriocarcinoma]]
| Germ- cell / Sex-Cord Stromal
| 
|-
| [[Epithelioid trophoblastic tumour]]
| Germ- cell / Sex-Cord Stromal
| 
|-
| [[Granulosa cell tumour]]
| Germ- cell / Sex-Cord Stromal
| 
|-
| [[Endometrial stromal sarcoma]]
| Germ- cell / Sex-Cord Stromal
| high grade
|-
| [[Lipid Cell tumour of ovary]]
| Germ- cell / Sex-Cord Stromal
| 
|-
| [[Sertoli cell tumour]]
| Germ- cell / Sex-Cord Stromal
| also [[Sertoli-Leydig cell tumour]] 
|-
| [[Leydig cell tumour]]
| Germ- cell / Sex-Cord Stromal
| also [[Sertoli-Leydig cell tumour]]
|-
| [[Epithelioid trophoblastic tumour]]
| Germ- cell / Sex-Cord Stromal
| <ref name=pmid10571512>{{Cite journal | last1 = Hamazaki| first1 = S.| last2 = Nakamoto| first2 = S.| last3 = Okino| first3 = T.| last4 = Tsukayama| first4 = C.| last5 = Mori| first5 = M.| last6 = Taguchi| first6 = K.| last7 = Okada| first7 = S.| title = Epithelioid trophoblastic tumor: morphological and immunohistochemical study of three lung lesions.| journal = Hum Pathol| volume = 30| issue = 11| pages = 1321-7| month = Nov| year = 1999| doi = | PMID = 10571512 }}</ref><ref name=pmid9808132>{{Cite journal | last1 = Shih| first1 = IM.| last2 = Kurman| first2 = RJ.| title = Epithelioid trophoblastic tumor: a neoplasm distinct from choriocarcinoma and placental site trophoblastic tumor simulating carcinoma.| journal = Am J Surg Pathol| volume = 22| issue = 11| pages = 1393-403| month = Nov| year = 1998| doi = | PMID = 9808132 }}</ref>
|-
| [[Placental site trophoblastic tumour]]
| Germ- cell / Sex-Cord Stromal
|(USCAP04, Gyn spec conf, case 3, vaginal
|-
| [[Testicular tumour of the adrenogenital syndrome]]
| Germ- cell / Sex-Cord Stromal
| Inhibin -ve, dark brown-green-black, similar to Leydig tumour
|-
| [[Extrauterine lesion of intermediate trophoblast]]
| Germ- cell / Sex-Cord Stromal
| very rare
|-
| [[Lymphoma]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Hodgkin's lymphoma]]
| Hematolymphoid / Histiocytic tumours
| syncytial or lymphocyte-depleted
|-
| [[Extramedullary monoblastic leukemia]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Histiocytic sarcoma]]
| Hematolymphoid / Histiocytic tumours
| "True" histiocytic lymphoma
|-
| [[Langerhans cell histiocytosis ]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Rosai-Dorfman disease]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Crystal-storing histiocytosis]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Erdheim-Chester disease]]
| Hematolymphoid / Histiocytic tumours
| foamy histiocytes
|-
| [[Rhinoscleroma]]
| Hematolymphoid / Histiocytic tumours
| foamy histiocytes and chronic inflammation
|-
| [[Granuloma annulare]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Anaplastic myeloma]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Extramedullary myeloid leukemia]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Extramedullary lymphoid leukemia]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Extramedullary megakaryoblastic leukemia]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Erythroleukemia]]
| Hematolymphoid / Histiocytic tumours
| may be EMA +ve
|-
| [[Juvenile xanthogranuloma]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Paraganglioma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| also [[pheochromocytoma]]
|-
| [[High grade olfactory neuroblastoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Epithelioid MPNST]]
| Neural - Neuroendocrine - Neuraxis Tumours
| reported to have focal melanocytic differentiation in some cases{{fact}}
|-
| [[Glioblastoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Epithelioid schwannoma / neurofibroma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Benign epithelioid nerve sheath tumour]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Chordoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Meningioma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| [[chordoid meningioma]]
|-
| [[Parachordoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| <ref name=pmid10478665>{{Cite journal | last1 = Folpe| first1 = AL.| last2 = Agoff| first2 = SN.| last3 = Willis| first3 = J.| last4 = Weiss| first4 = SW.| title = Parachordoma is immunohistochemically and cytogenetically distinct from axial chordoma and extraskeletal myxoid chondrosarcoma.| journal = Am J Surg Pathol| volume = 23| issue = 9| pages = 1059-67| month = Sep| year = 1999| doi = | PMID = 10478665 }}</ref>
|-
| [[Ependymoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Epithelioid perineurioma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Hemangioblastoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| may be extraneural
|-
| [[Rhabdoid tumour]]
| Neural - Neuroendocrine - Neuraxis Tumours
| INI1 -ve
|-
| [[Mucosal epithelioid nerve sheath tumour]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Neurothekeoma]]
| Neural - Neuroendocrine - Neuraxis Tumours
| 
|-
| [[Pleomorphic rhabdomyosarcoma]]
| Muscle-related tumours
| 
|-
| [[Epithelioid leiomyosarcoma]]
| Muscle-related tumours
| 
|-
| [[Epithelioid glomus tumour]]
| Muscle-related tumours
| 
|-
| [[Granular cell tumour]]
| Muscle-related tumours
| neural, non-neural types
|-
| [[Rhabdomyoma]]
| Muscle-related tumours
| 
|-
| [[Myopericytoma]]
| Muscle-related tumours
| <ref name=pmid16330949>{{Cite journal | last1 = Mentzel| first1 = T.| last2 = Dei Tos| first2 = AP.| last3 = Sapi| first3 = Z.| last4 = Kutzner| first4 = H.| title = Myopericytoma of skin and soft tissues: clinicopathologic and immunohistochemical study of 54 cases.| journal = Am J Surg Pathol| volume = 30| issue = 1| pages = 104-13| month = Jan| year = 2006| doi = | PMID = 16330949 }}</ref>
|-
| [[Epithelioid angiosarcoma]]
| Vascular tumours
| 
|-
| [[Epithelioid hemangioendothelioma]]
| Vascular tumours
| 
|-
| [[Epith sarcoma-like hemangioendothelioma ]]
| Vascular tumours
| 
|-
| [[Composite hemangioendothelioma]]
| Vascular tumours
| 
|-
| [[Hemangiopericytoma]]
| Vascular tumours
| 
|-
| [[Cutaneous epithelioid angiomatous nodule ]]
| Vascular tumours
| 
|-
| [[Bacillary angiomatosis ]]
| Vascular tumours
| 
|-
| [[Malignant pigmented villonodular synovitis]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Multicentric Reticulohistiocytosis]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Follicular dendritic cell sarcoma]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Interdigitating reticulum cell sarcoma]]
| Hematolymphoid / Histiocytic tumours
|S-100 +ve
|-
| [[Diffuse type tenosynovial giant cell tumour]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Malakoplakia]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Kikuchi's disease]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Xanthogranuloma]]
| Hematolymphoid / Histiocytic tumours
| 
|-
| [[Epithelioid sarcoma]]
| Miscellaneous mesencchymal tumours
| especially proximal variant
|-
| [[Synovial sarcoma]]
| Miscellaneous mesencchymal tumours
| poorly differentiated
|-
| [[Alveolar soft part sarcoma]]
| Miscellaneous mesencchymal tumours
| TFE3 +ve
|-
| [[Gastrointestinal stromal tumour]]
| Miscellaneous mesencchymal tumours
| 
|-
| [[Round cell liposarcoma]]
| Miscellaneous mesencchymal tumours
| 
|-
| [[Dedifferentiated liposarcoma]]
| Miscellaneous mesencchymal tumours
| 
|-
| [[Epithelioid variant of pleomorphic liposarcoma]]
| Miscellaneous mesencchymal tumours
| 
|-
| [[Polyphenotypic small cell tumour]]
| Miscellaneous mesencchymal tumours  
| 
|-
| [[Ewing Sarcoma / PNET, large cell type]]  
| Miscellaneous mesencchymal tumours
| 
|-
| [[Epithelioid fibrous histiocytoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Inflammatory malignant fibrous histiocytoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Sclerosing epithelioid fibrosarcoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Epithlelioid myofibroblastoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Angiomatoid malignant fibrous histiocytoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Inflammatory myxohyaline tumour of distal extremities with virocyte or Reed-Sternberg like cells]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Acral myxoinflammatory fibroblastic sarcoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Angiomyofibroblastoma]]
| Myofibroblastic - fibroblastic tumours
| 
|-
| [[Epithelioid osteosarcoma]]
| Chondro-osseous tumours
| 
|-
| [[Extraskeletal myxoid chondrosarcoma, high grade]]
| Chondro-osseous tumours
| 
|-
| [[Epithelioid multinodular osteoblastoma]]
| Chondro-osseous tumours
| may mimic [[osteosarcoma]]<ref name=pmid17667552>{{Cite journal | last1 = Zon Filippi| first1 = R.| last2 = Swee| first2 = RG.| last3 = Krishnan Unni| first3 = K.| title = Epithelioid multinodular osteoblastoma: a clinicopathologic analysis of 26 cases.| journal = Am J Surg Pathol| volume = 31| issue = 8| pages = 1265-8| month = Aug| year = 2007| doi = 10.1097/PAS.0b013e31803402e7| PMID = 17667552 }}</ref>
|-
| [[Radiation effect]]
| Miscellaneous
| 
|-
|}


==See also==
==See also==
Line 457: Line 33:
*[[Basics]].
*[[Basics]].
*[[Pleomorphic tumours]].
*[[Pleomorphic tumours]].
*[[Large epithelioid tumours]].


==References==
==References==
{{Reflist|2}}
{{Reflist|1}}


[[Category:Basics]]
[[Category:Basics]]

Latest revision as of 06:55, 1 November 2014

An tumour with an epithelioid morphology (epithelioid sarcoma). H&E stain.

Epithelioid cell lesions are very common in pathology. Malignant epithelioid lesions are most often carcinomas... but may be a large number different tumours.

Classification

Broadly, epithelioid lesions are split into:

General differential diagnosis

A short DDx:

Epithelioid sarcomas

All rules are made to be broken... some epithelioid lesions are sarcomas:[1]

Others:

Note:

See also

References

  1. ↑ Dei Tos AP, Wagner AJ, Modena P, Comandone A, Leyvraz S (August 2009). "Epithelioid soft tissue tumors". Semin. Oncol. 36 (4): 347–57. doi:10.1053/j.seminoncol.2009.06.005. PMID 19664495.
Retrieved from "https://librepathology.org/w/index.php?title=Epithelioid_cell_lesions&oldid=34640"