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Difference between revisions of "Soft tissue lesions"
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→Epithelioid sarcoma: more
(→Clear cell sarcoma: +DDx) |
(→Epithelioid sarcoma: more) |
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| Line 413: | Line 413: | ||
*Rare. | *Rare. | ||
*Adolescents, young adults. | *Adolescents, young adults. | ||
Subclassification:<ref name=pmid9042279>{{cite journal |author=Guillou L, Wadden C, Coindre JM, Krausz T, Fletcher CD |title="Proximal-type" epithelioid sarcoma, a distinctive aggressive neoplasm showing rhabdoid features. Clinicopathologic, immunohistochemical, and ultrastructural study of a series |journal=Am. J. Surg. Pathol. |volume=21 |issue=2 |pages=130–46 |year=1997 |month=February |pmid=9042279 |doi= |url=}}</ref> | |||
*Proximal type: | |||
**More aggressive. | |||
*Distal type: | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref>{{Ref WHOSTAB|205}}</ref> | Features:<ref>{{Ref WHOSTAB|205}}</ref> | ||
*Epithelioid morphology and spindle morphology. | *Epithelioid morphology and spindle morphology - which predominates is dependent on location (see subclassification). | ||
*Prominent nucleolus - ''' | *+/-Prominent nucleolus - '''distinctive feature'''. | ||
*Zonal necrosis with irregular border. | *Zonal necrosis with irregular border. | ||
**Descriptors: "Garland necrosis", necrosis with "scalloped border" = necrotic regions with irregular border. | **Descriptors: "Garland necrosis", necrosis with "scalloped border" = necrotic regions with irregular border. | ||
Subclassification:<ref name=pmid9042279>{{cite journal |author=Guillou L, Wadden C, Coindre JM, Krausz T, Fletcher CD |title="Proximal-type" epithelioid sarcoma, a distinctive aggressive neoplasm showing rhabdoid features. Clinicopathologic, immunohistochemical, and ultrastructural study of a series |journal=Am. J. Surg. Pathol. |volume=21 |issue=2 |pages=130–46 |year=1997 |month=February |pmid=9042279 |doi= |url=}}</ref> | |||
*Proximal-type (proximal location): | |||
**More epithelioid. | |||
*Distal-type (distal location): | |||
**More spindled. | |||
**Granuloma-like pattern. | |||
DDx: | DDx: | ||
*Carcinoma. | |||
*[[Rheumatoid nodule]]. | *[[Rheumatoid nodule]]. | ||
*[[Granuloma annulare]]. | *[[Granuloma annulare]]. | ||
=== | ===IHC=== | ||
Features:<ref name=pmid10452506>{{cite journal |author=Miettinen M, Fanburg-Smith JC, Virolainen M, Shmookler BM, Fetsch JF |title=Epithelioid sarcoma: an immunohistochemical analysis of 112 classical and variant cases and a discussion of the differential diagnosis |journal=Hum. Pathol. |volume=30 |issue=8 |pages=934–42 |year=1999 |month=August |pmid=10452506 |doi= |url=}}</ref> | Features:<ref name=pmid10452506>{{cite journal |author=Miettinen M, Fanburg-Smith JC, Virolainen M, Shmookler BM, Fetsch JF |title=Epithelioid sarcoma: an immunohistochemical analysis of 112 classical and variant cases and a discussion of the differential diagnosis |journal=Hum. Pathol. |volume=30 |issue=8 |pages=934–42 |year=1999 |month=August |pmid=10452506 |doi= |url=}}</ref> | ||
*INI1 (SMARCB1<ref>{{OMIM|601607}}</ref>) -ve.<ref name=pmid19997734>{{cite journal |author=Mentzel T |title=[Epithelioid sarcoma: morphologic variants and differential diagnosis] |language=German |journal=Pathologe |volume=31 |issue=2 |pages=135–41 |year=2010 |month=March |pmid=19997734 |doi=10.1007/s00292-009-1250-0 |url=}}</ref> | *INI1 (SMARCB1<ref>{{OMIM|601607}}</ref>) -ve.<ref name=pmid19997734>{{cite journal |author=Mentzel T |title=[Epithelioid sarcoma: morphologic variants and differential diagnosis] |language=German |journal=Pathologe |volume=31 |issue=2 |pages=135–41 |year=2010 |month=March |pmid=19997734 |doi=10.1007/s00292-009-1250-0 |url=}}</ref> | ||