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Difference between revisions of "Soft tissue lesions"
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==Grading== | |||
*Several systems exist. | |||
*The US-CAP advocates the use of the French system over the NCI system. | |||
**The French system is a better predictor metastases and mortality.<ref name=pmid8996162>{{cite journal |author=Guillou L, Coindre JM, Bonichon F, ''et al.'' |title=Comparative study of the National Cancer Institute and French Federation of Cancer Centers Sarcoma Group grading systems in a population of 410 adult patients with soft tissue sarcoma |journal=J. Clin. Oncol. |volume=15 |issue=1 |pages=350–62 |year=1997 |month=January |pmid=8996162 |doi= |url=}}</ref> | |||
===French system=== | |||
Overview:<ref name=pmid8996162/><ref name=uscap_stp>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/SoftTissue_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/SoftTissue_11protocol.pdf]. Accessed on: 12 April 2011.</ref> | |||
#Differentiation (score 1-3). | |||
#*De facto, this is mostly the ''histologic type''. | |||
#Mitotic rate (score 1-3). | |||
#Necrosis (score 0-2) | |||
Scoring: | |||
*Add all the points from the three components. | |||
Grade 1 = 2 or 3. | |||
Grade 2 = 4 or 5. ??? | |||
Grade 3 = | |||
=====Differentiation===== | |||
*Standardized for histologic types. | |||
*Most tumours = 3/3. | |||
Exceptions:<ref name=uscap_stp/> | |||
*Well-differentiated liposarcoma = 1. | |||
*Myxoid liposarcoma = 2. | |||
*Conventional liposarcoma = 2. | |||
*Fibrosarcoma = 2. | |||
*Myxofibrosarcoma =2. | |||
A group of tumours is not graded:<ref name=uscap_stp/> | |||
*[[MPNST]]. | |||
*[[Rhabdomyosarcoma]]. | |||
*[[Alveolar soft part sarcoma]]. | |||
*[[Clear cell sarcoma]]. | |||
*Extraskeletal myxoid chondrosarcoma. | |||
=====Mitotic rate===== | |||
*0-9 mitoses/10 HPF. | |||
*10-19 mitoses/10 HPF. | |||
*>=20 mitoses/10 HPF. | |||
Notes: | |||
*1 HPF = 0.1734 mm^2. | |||
**Most resident microscopes have a field of view = 0.2376 mm^2. | |||
***Thus, ~7.3 HPFs on a resident microscope corresponds to 10 US-CAP HPFs. | |||
=====Necrosis===== | |||
*None = score 0. | |||
*<=50% of tumour = score 1. | |||
*>50% of tumour = score 2. | |||
=Adipocytic tumours= | =Adipocytic tumours= | ||