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'''Large epithelioid tumours''' are common and represent a large [[differential diagnosis]] when viewed generally. | [[Image:Epithelioid angiosarcoma - very high mag.jpg|thumb|200px|right|A large epithelioid tumour ([[epithelioid angiosarcoma]]). [[H&E stain]].]] | ||
'''Large epithelioid tumours''' are common and represent a large [[differential diagnosis]] when viewed generally. | |||
[[Malignant]] epithelioid lesions are often [[carcinoma]]s... but may be a large number different tumours. | |||
A more general discussion of epithelioid lesions is in the ''[[epithelioid cell lesions]]'' article. Small epithelioid lesions are dealt with in the ''[[small round cell tumours]]'' article. | |||
==General differential diagnosis== | ==General differential diagnosis== | ||
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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| [[Myoepithelioma of soft tissue]] | | [[Myoepithelioma of soft tissue]] | ||
| Epithelial tumours | | Epithelial tumours | ||
| may mimic [[extraskeletal myxoid chondrosarcoma]] or proximal variant of [[ | | may mimic [[extraskeletal myxoid chondrosarcoma]] or proximal variant of [[epithelioid sarcoma]] | ||
|- | |- | ||
| [[Acinar cell carcinoma]] | | [[Acinar cell carcinoma]] | ||
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| <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> | | <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 | | Epithelial tumours | ||
| | | | ||
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| | | | ||
|- | |- | ||
| [[ | | [[Endometrial stromal sarcoma]] | ||
| Germ- cell / Sex-Cord Stromal | |||
| high grade | |||
|- | |||
| [[Lipid cell tumour of ovary]] | |||
| Germ- cell / Sex-Cord Stromal | | Germ- cell / Sex-Cord Stromal | ||
| | | | ||
|- | |- | ||
| [[ | | [[Sertoli cell tumour]] | ||
| Germ- cell / Sex-Cord Stromal | | Germ- cell / Sex-Cord Stromal | ||
| | | also [[Sertoli-Leydig cell tumour]] | ||
|- | |- | ||
| [[ | | [[Leydig cell tumour]] | ||
| Germ- cell / Sex-Cord Stromal | | Germ- cell / Sex-Cord Stromal | ||
| | | also [[Sertoli-Leydig cell tumour]] | ||
|- | |- | ||
| [[Epithelioid trophoblastic tumour]] | | [[Epithelioid trophoblastic tumour]] | ||
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| <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> | | <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 | | Germ- cell / Sex-Cord Stromal | ||
|(USCAP04, Gyn spec conf, case 3, vaginal | |(USCAP04, Gyn spec conf, case 3, vaginal | ||
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| "True" histiocytic lymphoma | | "True" histiocytic lymphoma | ||
|- | |- | ||
| [[ | | [[Langerhans cell histiocytosis ]] | ||
| Hematolymphoid / Histiocytic tumours | | Hematolymphoid / Histiocytic tumours | ||
| | | | ||
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| | | | ||
|- | |- | ||
| [[Extramedullary megakaryoblastic | | [[Extramedullary megakaryoblastic leukemia]] | ||
| Hematolymphoid / Histiocytic tumours | | Hematolymphoid / Histiocytic tumours | ||
| | | | ||
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| also [[pheochromocytoma]] | | also [[pheochromocytoma]] | ||
|- | |- | ||
| [[ | | High grade [[olfactory neuroblastoma]] | ||
| Neural - Neuroendocrine - Neuraxis Tumours | | Neural - Neuroendocrine - Neuraxis Tumours | ||
| | | | ||
|- | |- | ||
| [[ | | Epithelioid [[MPNST]] | ||
| Neural - Neuroendocrine - Neuraxis Tumours | | Neural - Neuroendocrine - Neuraxis Tumours | ||
| reported to have focal melanocytic differentiation in some cases{{fact}} | | reported to have focal melanocytic differentiation in some cases{{fact}} | ||
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| | | | ||
|- | |- | ||
| [[ | | [[Rhabdomyosarcoma]], not otherwise specified ([[pleomorphic rhabdomyosarcoma]]) | ||
| Muscle-related tumours | | Muscle-related tumours | ||
| | | | ||
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| | | | ||
|- | |- | ||
| [[Epithelioid glomus | | [[Epithelioid glomus tumour]] | ||
| Muscle-related tumours | | Muscle-related tumours | ||
| | | | ||
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| | | | ||
|- | |- | ||
| [[ | | [[Epithelioid sarcoma-like hemangioendothelioma]] | ||
| Vascular tumours | | Vascular tumours | ||
| | | <ref name=pmid12502927>{{Cite journal | last1 = Billings | first1 = SD. | last2 = Folpe | first2 = AL. | last3 = Weiss | first3 = SW. | title = Epithelioid sarcoma-like hemangioendothelioma. | journal = Am J Surg Pathol | volume = 27 | issue = 1 | pages = 48-57 | month = Jan | year = 2003 | doi = | PMID = 12502927 }}</ref> | ||
|- | |- | ||
| [[Composite hemangioendothelioma]] | | [[Composite hemangioendothelioma]] | ||
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|S-100 +ve | |S-100 +ve | ||
|- | |- | ||
| [[Diffuse type tenosynovial giant cell | | [[Diffuse type tenosynovial giant cell tumour]] | ||
| Hematolymphoid / Histiocytic tumours | | Hematolymphoid / Histiocytic tumours | ||
| | | | ||
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| | | | ||
|- | |- | ||
| [[Inflammatory myxohyaline | | [[Inflammatory myxohyaline tumour of distal extremities with virocyte or Reed-Sternberg like cells]] | ||
| Myofibroblastic - fibroblastic tumours | | Myofibroblastic - fibroblastic tumours | ||
| | | | ||
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| | | | ||
|- | |- | ||
| [[ | | Epithelioid [[osteosarcoma]] | ||
| Chondro-osseous tumours | | Chondro-osseous tumours | ||
| | | <ref>{{Cite journal | last1 = Amanatullah | first1 = DF. | last2 = Ngann | first2 = KK. | last3 = Borys | first3 = D. | last4 = Tamurian | first4 = RM. | title = Progression of aggressive metastatic carcinosarcoma after treatment of epithelioid osteosarcoma. | journal = Orthopedics | volume = 33 | issue = 6 | pages = 445 | month = Jun | year = 2010 | doi = 10.3928/01477447-20100429-26 | PMID = 20806764 }}</ref> | ||
|- | |- | ||
| [[Extraskeletal myxoid chondrosarcoma, high grade | | [[Extraskeletal myxoid chondrosarcoma]], high grade | ||
| Chondro-osseous tumours | | Chondro-osseous tumours | ||
| | | | ||
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*[[Basics]]. | *[[Basics]]. | ||
*[[Pleomorphic tumours]]. | *[[Pleomorphic tumours]]. | ||
*[[Small round cell tumours]]. | |||
==References== | ==References== |
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