Bone and Soft Tissue Pathology Specimens and 127 Surgicals (Biopsies and Resections)
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Who, How and What of Pathology of Soft Tissue Sarcoma
Editorial Page 1 of 11 Who, how and what of pathology of soft tissue sarcoma Salvatore Lorenzo Renne Anatomic Pathology Unit, Humanitas Research Hospital, Humanitas University, Rozzano, MI 20089, Italy Correspondence to: Salvatore Lorenzo Renne. Adjunct Teaching Professor, Anatomic Pathology Unit, Humanitas Research Hospital, Humanitas University, Via Manzoni 56, Rozzano, MI 20089, Italy. Email: [email protected]. Submitted Aug 06, 2018. Accepted for publication Aug 23, 2018. doi: 10.21037/cco.2018.10.09 View this article at: http://dx.doi.org/10.21037/cco.2018.10.09 Introduction to soft tissue sarcoma (STS) adipocytes (lipoma, spindle cells lipoma, hibernoma, well- pathology differentiated liposarcoma (LPS), myxoid LPS, etc.). One chapter is dedicated to specific entities “of uncertain STS is a generic term that refers to a heterogeneous group differentiation” that are well-characterized entities that do of rare neoplastic diseases. The aim of this review is to not readily resemble any normal mesenchymal cells (as the discuss the role of pathology in the multidisciplinary Ewing sarcoma or the synovial sarcoma—a clear misnomer). management of STS patients. This will be done: (I) The last chapter is dedicated to those sarcomas that do illustrating the framework for the current classification; (II) not follow in any of the previously listed diagnosis and are examining the characteristics that allows an expert diagnosis; therefore called “undifferentiated/unclassified sarcomas” (III) describing the role of the sarcoma pathologist -
A Rare Bone Tumor
OPEN ACCESS L E T T E R T O T H E E D I T O R Periosteal Desmoplastic Fibroma of Radius: A Rare Bone Tumor Aniqua Saleem1,* Hira Saleem2 1 Radiology Department, District Head Quarters Hospital, Rawalpindi Medical University, Rawalpindi 2 Department of Surgery, Shifa International Hospital, Islamabad. Correspondence*: Dr. Aniqua Saleem, Radiology Department, District Head Quarters Hospital, Rawalpindi Medical University, Rawalpindi E-mail: [email protected] © 2019, Saleem et al, Submitted: 05-04-2019 Accepted: 09-06-2019 Conflict of Interest: None Source of Support: Nil This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. DEAR SIR Desmoplastic fibroma is an extremely rare tumor of enhancement on post contrast images and with adjacent bone with a reported incidence of 0.11 % of all primary bone involvement as was evident by focal cortical inter- bone tumors. The most common site of involvement is ruption, mild endosteal thickening and irregularity and mandible (reported incidence 22% of all Desmoplastic also mild ulnar shaft remodeling (Fig. 3a, 3b). To further fibroma cases) followed by metaphysis of long bones. characterize the lesion, Tc99 MDP (methylene diphos- Involvement of forearm especially involving periosteum phonate) bone scan was also performed which showed is seldom reported. Prompt diagnosis and adequate active bone involvement in left distal radial shaft. management is important for limb salvage and restora- tion of limb function. [1-3] An 11-year-old boy presented with painful mild swelling of left forearm for a month, with no significant past med- ical history or any history of trauma. -
Complete Case of a Rare but Benign Soft Tissue Tumor
Hindawi Case Reports in Orthopedics Volume 2019, Article ID 6840693, 5 pages https://doi.org/10.1155/2019/6840693 Case Report Hibernoma of the Upper Extremity: Complete Case of a Rare but Benign Soft Tissue Tumor Thomas Reichel ,1 Kilian Rueckl,1 Annabel Fenwick,1,2 Niklas Vogt,3 Maximilian Rudert,1 and Piet Plumhoff1 1Department of Orthopedic Surgery, Koenig-Ludwig-Haus, University of Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany 2Department of Trauma Surgery, Klinikum Augsburg, 86156 Augsburg, Germany 3Department of Pathology, University of Wuerzburg, 97080 Wuerzburg, Germany Correspondence should be addressed to Thomas Reichel; [email protected] Received 26 February 2019; Accepted 14 April 2019; Published 21 May 2019 Academic Editor: Elke R. Ahlmann Copyright © 2019 Thomas Reichel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hibernoma is a rare benign lipomatous tumor showing differentiation of brown fatty tissue. To the author’s best knowledge, there is no known case of malignant transformation or metastasis. Due to their slow, noninfiltrating growth hibernomas are often an incidental finding in the third or fourth decade of life. The vast majority are located in the thigh, neck, and periscapular region. A diagnostic workup includes ultrasound and contrast-enhanced MRI. Differential diagnosis is benign lipoma, well- differentiated liposarcoma, and rhabdomyoma. An incisional biopsy followed by marginal resection of the tumor is the standard of care, and recurrence after complete resection is not reported. The current paper presents diagnostic and intraoperative findings of a hibernoma of the upper arm and reviews similar reports in the current literature. -
Nodular Fasciitis of the Pectoralis Muscle in a 54-Year-Old Woman
ACS Case Reviews in Surgery Vol. 2, No. 3 Nodular Fasciitis of the Pectoralis Muscle in a 54-Year-Old Woman AUTHORS: CORRESPONDENCE AUTHOR: AUTHOR AFFILIATIONS: Christopher D. Kannera; Divya Sharma, MDb; Dr. Jaime D Lewis a. Medical Student, University of Cincinnati College Jaime D Lewis, MD, FACSc UC Health Women’s Center of Medicine, Cincinnati, Ohio 7675 Wellness Way b. Department of Pathology and Laboratory West Chester, Ohio 45069 Medicine, University of Cincinnati College of Phone: (513) 584-8900 Medicine, Cincinnati, Ohio Email: [email protected] c. Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio Background A 54-year-old woman presented with a breast mass found to be nodular fasciitis of the right pectoralis muscle. Summary A 54-year-old woman presented to a breast surgeon for evaluation of a painful right breast mass. Initial mammography was unrevealing. Ultrasound revealed a right pectoral mass extending into the soft tissue of the breast. Core needle biopsy specimen revealed features suggestive of low grade sarcoma. Findings on computed tomography (CT) and magnetic resonance imaging (MRI) were nonspecific and wide local excision was subsequently performed. Pathologic characteristics were consistent with nodular fasciitis. This benign proliferation of fibroblasts and myofibroblasts frequently raises concern for malignant neoplasms due to its rapid, infiltrative growth, and nonspecific imaging characteristics. Thus, it is often identified by its characteristic features on surgical pathology following excision. On rare occasions when it is managed with surveillance, nodular fasciitis frequently demonstrates spontaneous regression. Conclusion Nodular fasciitis is a benign growth with a tendency for spontaneous regression, which exhibits clinical features that often invoke suspicion of malignancy. -
Soft Tissue Cytopathology: a Practical Approach Liron Pantanowitz, MD
4/1/2020 Soft Tissue Cytopathology: A Practical Approach Liron Pantanowitz, MD Department of Pathology University of Pittsburgh Medical Center [email protected] What does the clinician want to know? • Is the lesion of mesenchymal origin or not? • Is it begin or malignant? • If it is malignant: – Is it a small round cell tumor & if so what type? – Is this soft tissue neoplasm of low or high‐grade? Practical diagnostic categories used in soft tissue cytopathology 1 4/1/2020 Practical approach to interpret FNA of soft tissue lesions involves: 1. Predominant cell type present 2. Background pattern recognition Cell Type Stroma • Lipomatous • Myxoid • Spindle cells • Other • Giant cells • Round cells • Epithelioid • Pleomorphic Lipomatous Spindle cell Small round cell Fibrolipoma Leiomyosarcoma Ewing sarcoma Myxoid Epithelioid Pleomorphic Myxoid sarcoma Clear cell sarcoma Pleomorphic sarcoma 2 4/1/2020 CASE #1 • 45yr Man • Thigh mass (fatty) • CNB with TP (DQ stain) DQ Mag 20x ALT –Floret cells 3 4/1/2020 Adipocytic Lesions • Lipoma ‐ most common soft tissue neoplasm • Liposarcoma ‐ most common adult soft tissue sarcoma • Benign features: – Large, univacuolated adipocytes of uniform size – Small, bland nuclei without atypia • Malignant features: – Lipoblasts, pleomorphic giant cells or round cells – Vascular myxoid stroma • Pitfalls: Lipophages & pseudo‐lipoblasts • Fat easily destroyed (oil globules) & lost with preparation Lipoma & Variants . Angiolipoma (prominent vessels) . Myolipoma (smooth muscle) . Angiomyolipoma (vessels + smooth muscle) . Myelolipoma (hematopoietic elements) . Chondroid lipoma (chondromyxoid matrix) . Spindle cell lipoma (CD34+ spindle cells) . Pleomorphic lipoma . Intramuscular lipoma Lipoma 4 4/1/2020 Angiolipoma Myelolipoma Lipoblasts • Typically multivacuolated • Can be monovacuolated • Hyperchromatic nuclei • Irregular (scalloped) nuclei • Nucleoli not typically seen 5 4/1/2020 WD liposarcoma Layfield et al. -
The Use of High Tumescent Power Assisted Liposuction in the Treatment of Madelung’S Collar
Letter to the Editor The use of high tumescent power assisted liposuction in the treatment of Madelung’s collar Henryk Witmanowski1,2, Łukasz Banasiak1, Grzegorz Kierzynka1, Jarosław Markowicz1, Jerzy Kolasiński1, Katarzyna Błochowiak3, Paweł Szychta1,4 1Department of Plastic, Reconstructive and Aesthetic Surgery, Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland 2Department of Physiology, Poznan University of Medical Sciences, Poznan, Poland 3Department of the Oral Surgery, Poznan University of Medical Sciences, Poznan, Poland 4Department of Oncological Surgery and Breast Diseases, Polish Mother’s Memorial Hospital-Research Institute, Lodz, Poland Adv Dermatol Allergol 2017; XXXIV (4): 366–371 DOI: https://doi.org/10.5114/ada.2017.69319 Mild symmetrical lipomatosis (plural symmetrical The disease most commonly takes a proximal form lipomatosis, multiple symmetric lipomatosis – MSL), which takes the following areas of the body with the fol- also known as Madelung’s disease or Launois-Bensaude lowing frequency: the genial area 92.3%, cervical region syndrome is a rare disease of unknown etiology, first de- 67.7%, shoulder region 54.8%, abdominal 45.2%, chest scribed by Brodie in 1846, Madelung in 1888, and Launois 41.9%, thigh and pelvic rim 32.3% [11, 12]. The periph- with Bensaude in 1898 [1–3]. eral type mainly locates on both sides at the level of the Madelung’s disease incidence is 1 : 250000 [4]. Mul- hands, feet and knees, this is definitely a rarer form of tiple symmetric lipomatosis occurs mainly in the inhabit- the disease. The mixed form is described very rarely. The ants of the Mediterranean area and Eastern Europe, in specified central type is also engaged primarily around males (male to female ratio is 20 : 1), aged 30–70 years, the lower torso, and intermediate parts of the legs. -
A Computational Approach for Defining a Signature of Β-Cell Golgi Stress in Diabetes Mellitus
Page 1 of 781 Diabetes A Computational Approach for Defining a Signature of β-Cell Golgi Stress in Diabetes Mellitus Robert N. Bone1,6,7, Olufunmilola Oyebamiji2, Sayali Talware2, Sharmila Selvaraj2, Preethi Krishnan3,6, Farooq Syed1,6,7, Huanmei Wu2, Carmella Evans-Molina 1,3,4,5,6,7,8* Departments of 1Pediatrics, 3Medicine, 4Anatomy, Cell Biology & Physiology, 5Biochemistry & Molecular Biology, the 6Center for Diabetes & Metabolic Diseases, and the 7Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN 46202; 2Department of BioHealth Informatics, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202; 8Roudebush VA Medical Center, Indianapolis, IN 46202. *Corresponding Author(s): Carmella Evans-Molina, MD, PhD ([email protected]) Indiana University School of Medicine, 635 Barnhill Drive, MS 2031A, Indianapolis, IN 46202, Telephone: (317) 274-4145, Fax (317) 274-4107 Running Title: Golgi Stress Response in Diabetes Word Count: 4358 Number of Figures: 6 Keywords: Golgi apparatus stress, Islets, β cell, Type 1 diabetes, Type 2 diabetes 1 Diabetes Publish Ahead of Print, published online August 20, 2020 Diabetes Page 2 of 781 ABSTRACT The Golgi apparatus (GA) is an important site of insulin processing and granule maturation, but whether GA organelle dysfunction and GA stress are present in the diabetic β-cell has not been tested. We utilized an informatics-based approach to develop a transcriptional signature of β-cell GA stress using existing RNA sequencing and microarray datasets generated using human islets from donors with diabetes and islets where type 1(T1D) and type 2 diabetes (T2D) had been modeled ex vivo. To narrow our results to GA-specific genes, we applied a filter set of 1,030 genes accepted as GA associated. -
Deubiquitinases in Cancer: New Functions and Therapeutic Options
Oncogene (2012) 31, 2373–2388 & 2012 Macmillan Publishers Limited All rights reserved 0950-9232/12 www.nature.com/onc REVIEW Deubiquitinases in cancer: new functions and therapeutic options JM Fraile1, V Quesada1, D Rodrı´guez, JMP Freije and C Lo´pez-Otı´n Departamento de Bioquı´mica y Biologı´a Molecular, Facultad de Medicina, Instituto Universitario de Oncologı´a, Universidad de Oviedo, Oviedo, Spain Deubiquitinases (DUBs) have fundamental roles in the Hunter, 2010). Consistent with the functional relevance ubiquitin system through their ability to specifically of proteases in these processes, alterations in their deconjugate ubiquitin from targeted proteins. The human structure or in the mechanisms controlling their genome encodes at least 98 DUBs, which can be grouped spatiotemporal expression patterns and activities cause into 6 families, reflecting the need for specificity in diverse pathologies such as arthritis, neurodegenerative their function. The activity of these enzymes affects the alterations, cardiovascular diseases and cancer. Accord- turnover rate, activation, recycling and localization ingly, many proteases are an important focus of of multiple proteins, which in turn is essential for attention for the pharmaceutical industry either as drug cell homeostasis, protein stability and a wide range of targets or as diagnostic and prognostic biomarkers signaling pathways. Consistent with this, altered DUB (Turk, 2006; Drag and Salvesen, 2010). function has been related to several diseases, including The recent availability of the genome sequence cancer. Thus, multiple DUBs have been classified as of different organisms has facilitated the identification oncogenes or tumor suppressors because of their regula- of their entire protease repertoire, which has been tory functions on the activity of other proteins involved in defined as degradome (Lopez-Otin and Overall, 2002). -
A Comparison of Imaging Modalities for the Diagnosis of Osteomyelitis
A comparison of imaging modalities for the diagnosis of osteomyelitis Brandon J. Smith1, Grant S. Buchanan2, Franklin D. Shuler2 Author Affiliations: 1. Joan C Edwards School of Medicine, Marshall University, Huntington, West Virginia 2. Marshall University The authors have no financial disclosures to declare and no conflicts of interest to report. Corresponding Author: Brandon J. Smith Marshall University Joan C. Edwards School of Medicine Huntington, West Virginia Email: [email protected] Abstract Osteomyelitis is an increasingly common pathology that often poses a diagnostic challenge to clinicians. Accurate and timely diagnosis is critical to preventing complications that can result in the loss of life or limb. In addition to history, physical exam, and laboratory studies, diagnostic imaging plays an essential role in the diagnostic process. This narrative review article discusses various imaging modalities employed to diagnose osteomyelitis: plain films, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, bone scintigraphy, and positron emission tomography (PET). Articles were obtained from PubMed and screened for relevance to the topic of diagnostic imaging for osteomyelitis. The authors conclude that plain films are an appropriate first step, as they may reveal osteolytic changes and can help rule out alternative pathology. MRI is often the most appropriate second study, as it is highly sensitive and can detect bone marrow changes within days of an infection. Other studies such as CT, ultrasound, and bone scintigraphy may be useful in patients who cannot undergo MRI. CT is useful for identifying necrotic bone in chronic infections. Ultrasound may be useful in children or those with sickle-cell disease. Bone scintigraphy is particularly useful for vertebral osteomyelitis. -
Appendix 4 WHO Classification of Soft Tissue Tumours17
S3.02 The histological type and subtype of the tumour must be documented wherever possible. CS3.02a Accepting the limitations of sampling and with the use of diagnostic common sense, tumour type should be assigned according to the WHO system 17, wherever possible. (See Appendix 4 for full list). CS3.02b If precise tumour typing is not possible, generic descriptions to describe the tumour may be useful (eg myxoid, pleomorphic, spindle cell, round cell etc), together with the growth pattern (eg fascicular, sheet-like, storiform etc). (See G3.01). CS3.02c If the reporting pathologist is unfamiliar or lacks confidence with the myriad possible diagnoses, then at this point a decision to send the case away without delay for an expert opinion would be the most sensible option. Referral to the pathologist at the nearest Regional Sarcoma Service would be appropriate in the first instance. Further International Pathology Review may then be obtained by the treating Regional Sarcoma Multidisciplinary Team if required. Adequate review will require submission of full clinical and imaging information as well as histological sections and paraffin block material. Appendix 4 WHO classification of soft tissue tumours17 ADIPOCYTIC TUMOURS Benign Lipoma 8850/0* Lipomatosis 8850/0 Lipomatosis of nerve 8850/0 Lipoblastoma / Lipoblastomatosis 8881/0 Angiolipoma 8861/0 Myolipoma 8890/0 Chondroid lipoma 8862/0 Extrarenal angiomyolipoma 8860/0 Extra-adrenal myelolipoma 8870/0 Spindle cell/ 8857/0 Pleomorphic lipoma 8854/0 Hibernoma 8880/0 Intermediate (locally -
Soft Tissue Tumor Pathology: New Diagnostic Immunohistochemical Markers Leona A
S EMINARS IN D IAGNOSTIC P ATHOLOGY ] (2015) ]]]– ]]] Available online at www.sciencedirect.com www.elsevier.com/locate/semdp Soft tissue tumor pathology: New diagnostic immunohistochemical markers Leona A. Doyle, MD Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, Massachusetts article info abstract Keywords: Recent insights into the pathogenesis of various soft tissue tumors, along with the Soft tissue identification of recurrent molecular alterations characteristic of specific tumor types, Tumor have resulted in the development of many diagnostically useful immunohistochemical Sarcoma markers. In some cases, expression of these markers is significantly associated with Immunohistochemistry distinctive clinical and histologic features, which may impart prognostic or predictive Molecular genetics information. This review outlines new diagnostic immunohistochemical markers in soft tissue tumor pathology, emphasizing their utility in clinical practice and potential pitfalls, molecular correlates and clinical associations. & 2015 Elsevier Inc. All rights reserved. Introduction shows MYC amplification. Finally, so-called lineage specific markers, which tend to show nuclear staining and in general fi Over the last 10 years, many novel immunohistochemical are not strictly speci c to a given lineage, have also emerged markers for use in the evaluation of soft tissue tumors have as useful markers, not only in soft tissue pathology but also been described. This has largely been due to new insights -
Bone & Soft Tissue Pathology Fellowship
Bone & Soft Tissue Pathology Fellowship The Department of Pathology at Memorial Availability: July 2023 Sloan Kettering Cancer Center offers a one- year fellowship training program in bone and Number of Positions: One soft tissue pathology. The fellowship begins on Length of Program: One Year July 1st and ends on June 30th the following year. All fellows should have completed Deadline: August 1, for appoint- residency training in anatomic pathology and ments beginning 2 years later (ie. be certified (or eligible for certification) by 8/1/2021 for start date 7/1/2023). the American Board of Pathology. Early application is acceptable because completed applications may be During the sub-specialty fellowship year, the considered on a rolling basis. fellow will have the opportunity to study our large volume of quality in-house and submitted How to Apply: Apply Online material, departmental consultation case Only complete applications will material, as well as recommended reading of be reviewed. Once applicants have literature to achieve adequate competence submitted their applications, they will in the pathologic diagnosis, staging, and need to send the following documents: prognostication of a wide variety of bone and • Three letters of recommendation from soft tissue tumors. In addition, the fellow an institution in which the applicant will have the opportunity to perform clinico- has trained. Letters should be pathologic and molecular correlations. addressed to Dr. Ronald Ghossein, the The fellow will serve as a consultant to the program director. Please request letter oncologic pathology fellows in the orientation, writers add the following line after gross dissection and morphologic evaluation the heading (RE: Candidate’s Name, of bone and soft tissue specimens.