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Difference between revisions of "Glomus tumour"
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| Width = | | Width = | ||
| Caption = Glomus tumour. [[H&E stain]]. | | Caption = Glomus tumour. [[H&E stain]]. | ||
| Micro = sheets of equally-spaced cells ("cookie cutter appearance"), polygonal cells | | Micro = sheets of equally-spaced cells ("cookie cutter appearance"), polygonal cells +/-identifiable cellular borders, thin-walled blood vessels, moderate clear cytoplasm | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = | ||
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| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = [[skin]]/soft tissue - classically subungal | | Site = [[skin]]/soft tissue - classically subungal (under the nail) | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = +/-[[neurofibromatosis 1]] | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = | ||
| Symptoms = [[painful skin lesion]] | | Symptoms = [[painful skin lesion]], cold intolerance, point tenderness | ||
| Prevalence = uncommon | | Prevalence = uncommon | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = usu. good | | Prognosis = usu. good (benign), rarely malignant | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = excision | |||
}} | }} | ||
'''Glomus tumours''', also known as '''glomangioma''', are painful, perivascular tumour that are classically periungual. | '''Glomus tumours''', also known as '''glomangioma''', are painful, perivascular tumour that are classically periungual. | ||
It should not be confused with ''[[paraganglioma]]'', which were once called glomus tumour. | It should '''not''' be confused with ''[[paraganglioma]]'', which were once called glomus tumour. | ||
This tumour is classified as a ''perivascular tumour'' (also ''pericytic tumour'') which is a subset of [[soft tissue tumours]]. | This tumour is classified as a ''perivascular tumour'' (also ''pericytic tumour'') which is a subset of [[soft tissue tumours]]. | ||
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*Tumour derived from smooth muscle cell.<ref name=pmid18788860>{{cite journal |author=Gombos Z, Zhang PJ |title=Glomus tumor |journal=Arch. Pathol. Lab. Med. |volume=132 |issue=9 |pages=1448–52 |year=2008 |month=September |pmid=18788860 |doi=10.1043/1543-2165(2008)132[1448:GT]2.0.CO;2 |url=}}</ref> | *Tumour derived from smooth muscle cell.<ref name=pmid18788860>{{cite journal |author=Gombos Z, Zhang PJ |title=Glomus tumor |journal=Arch. Pathol. Lab. Med. |volume=132 |issue=9 |pages=1448–52 |year=2008 |month=September |pmid=18788860 |doi=10.1043/1543-2165(2008)132[1448:GT]2.0.CO;2 |url=}}</ref> | ||
*Usually benign. | *Usually benign. | ||
**Malignant variant exists - extremely rare. | **Malignant variant exists (known as ''glomangiosarcoma'') - extremely rare.<ref>{{cite journal |authors=Alhroub OA, Mahameed SA, Abdelhafez MO, Alhroub A, Hour H, Hasasna N, Kamal N |title=A case of malignant glomus tumor (glomangiosarcoma) of the nasal cavity |journal=J Surg Case Rep |volume=2022 |issue=1 |pages=rjab641 |date=January 2022 |pmid=35096369 |pmc=8791658 |doi=10.1093/jscr/rjab641 |url=}}</ref> | ||
*May be associated with [[neurofibromatosis 1]].<ref name=pmid25426397>{{cite journal |authors=Harrison B, Sammer D |title=Glomus tumors and neurofibromatosis: a newly recognized association |journal=Plast Reconstr Surg Glob Open |volume=2 |issue=9 |pages=e214 |date=September 2014 |pmid=25426397 |pmc=4229273 |doi=10.1097/GOX.0000000000000144 |url=}}</ref><ref name=pmid24685357>{{cite journal |authors=Kumar MG, Emnett RJ, Bayliss SJ, Gutmann DH |title=Glomus tumors in individuals with neurofibromatosis type 1 |journal=J Am Acad Dermatol |volume=71 |issue=1 |pages=44–8 |date=July 2014 |pmid=24685357 |doi=10.1016/j.jaad.2014.01.913 |url=}}</ref> | |||
Clinical: | Clinical - classic triad:<ref name=pmid36590779>{{cite journal |authors=Dhingra M, Niraula BB, Regmi A, Bansal S, Singh V, Phulware RH |title=Glomus Tumour of Hand--A Commonly Misdiagnosed Pathology: A Case Series |journal=J West Afr Coll Surg |volume=12 |issue=4 |pages=39–45 |date=2022 |pmid=36590779 |pmc=9802603 |doi=10.4103/jwas.jwas_171_22 |url=}}</ref> | ||
*[[ | *Pain - see ''[[painful skin lesion]]s''. | ||
*Point tenderness. | |||
*Cold intolerance. | |||
==Gross== | ==Gross== | ||
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Features:<ref name=ouhsc>URL: [http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm]. Accessed on: 19 October 2010.</ref> | Features:<ref name=ouhsc>URL: [http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm]. Accessed on: 19 October 2010.</ref> | ||
*Sheets of equally-spaced cells ("cookie cutter appearance") - '''key feature'''. | *Sheets of equally-spaced cells ("cookie cutter appearance") - '''key feature'''. | ||
*Polygonal cells | *Polygonal cells +/- identifiable cellular borders. | ||
*Thin-walled blood vessels. | *Thin-walled blood vessels. | ||
**May vaguely resemble antlers ([[staghorn vessels]]). | **May vaguely resemble antlers ([[staghorn vessels]]). | ||
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*The regular cell spacing is called "cookie cutter appearance". It looks like the cells were created with a cookie cutter; the spacing between cell is equal and they all look very similar. | *The regular cell spacing is called "cookie cutter appearance". It looks like the cells were created with a cookie cutter; the spacing between cell is equal and they all look very similar. | ||
*Should be perivascular - abut endothelial cells. | *Should be perivascular - abut endothelial cells. | ||
*Myxoid matrix common.<ref name=pmid25614464>{{cite journal |authors=Mravic M, LaChaud G, Nguyen A, Scott MA, Dry SM, James AW |title=Clinical and histopathological diagnosis of glomus tumor: an institutional experience of 138 cases |journal=Int J Surg Pathol |volume=23 |issue=3 |pages=181–8 |date=May 2015 |pmid=25614464 |pmc=4498398 |doi=10.1177/1066896914567330 |url=}}</ref> | |||
DDx - Why it is not a(n) ...<ref name=ouhsc>URL: [http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm]. Accessed on: 19 October 2010.</ref> | DDx - Why it is not a(n) ...<ref name=ouhsc>URL: [http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/Z0B003-PQ01-M.htm]. Accessed on: 19 October 2010.</ref> | ||
*[[Spiradenoma]] - also vascular and 'blue' but epithelial, often on the head (or at least chest and up). | |||
*Solid and cystic hidradenoma - epithelial and less 'blue' | |||
*[[Angiosarcoma]] - has nuclear atypia. | *[[Angiosarcoma]] - has nuclear atypia. | ||
*[[Dermatofibroma]] - spindle cell lesion. | *[[Dermatofibroma]] - spindle cell lesion. | ||
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Others: | Others: | ||
*S100 -ve. | *S100 -ve. | ||
*Calponin +ve. | |||
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