DOCSLIB.ORG

Fibrosarcoma Developing in the Parotid Gland: an Unusual Presentation 1Shagufta Qadri, 2Nishat Afroz, 3Divya Rabindranath, 4Shakeba Qadri

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Fibrosarcoma Developing in the Parotid Gland: an Unusual Presentation 1Shagufta Qadri, 2Nishat Afroz, 3Divya Rabindranath, 4Shakeba Qadri IJHNS Fibrosarcoma developing in the Parotid10.5005/jp-journals-10001-1233 Gland: An Unusual Presentation CASE REPORT Fibrosarcoma developing in the Parotid Gland: An Unusual Presentation 1Shagufta Qadri, 2Nishat Afroz, 3Divya Rabindranath, 4Shakeba Qadri ABSTRACT soft-part sarcoma.2 Fibrosarcoma of the head and neck Primary sarcomas of the salivary glands occur rarely with few represents 5% of all fibrosarcomas. Microscopically, cases having been reported. Fibrosarcoma is a rare type of fibrosarcoma shows an intense proliferation of spindle primary sarcoma with a poor prognosis and low life expectancy. shaped cells, varying a little in their size and shape Microscopically, these tumors resemble their counterparts and arranged in parallel bands which partly cross each encountered in other areas. They can be easily confused with 3 spindle cell (sarcomatoid) carcinomas, myoepithelial carcino- other at acute angles (herring bone pattern). They show mas or malignant melanomas. We present an unusual case of a considerable morphological and histopathological a primary fibrosarcoma that arose in the right parotid gland of overlapping with spindle cell (sarcomatoid) carcinomas, a 50 years male, who presented with a large nodular mass in myoepithelial carcinomas and malignant melanomas. the right preauricular region. Computed tomography (CT) scan revealed a tumor arising from the right parotid gland. A near total Hence, immunohistochemistry is mandatory to diffe- parotidectomy was performed and the histopathology report rentiate fibrosarcoma from the above-mentioned tumors. showed neoplastic spindle cells predominantly arranged in a Malignant spindle cell tumors within the salivary ‘herring bone’ pattern. On immunohistochemistry, the tumor gland is a diagnostic challenge for the pathologist. was positive for vimentin and was negative for pancytokeratin and S-100, which lead to a firm diagnosis of fibrosarcoma. Through this report, the authors are elucidating the existence of fibrosarcoma in the parotid gland and simul- Keywords: Fibrosarcoma, Parotid gland, Salivary gland, Sarcoma. taneously emphasizing the need for a high index of suspi- cion to rule out other lesions with a similar appearance in How to cite this article: Qadri S, Afroz N, Rabindranath D, Qadri S. Fibrosarcoma developing in the Parotid Gland: An order to reach the correct diagnosis and form an effective Unusual Presentation. Int J Head Neck Surg 2015;6(2):99-102. plan of management. Nil Source of support: CASE REPORT Conflict of interest: None A 50 years Indian male presented to the Outpatient Clinic of the Department of Surgery with a large mass INTRODUCTION in the right preauricular region for the past 8 months, Parotid malignancies represent 1 to 3% of all head and which progressively increased from a small nodule to the 1 neck cancers, while sarcomas comprise only 0.3 to 1.5% of present size. No history of ionizing radiation exposure 2 all major salivary gland neoplasms. The most frequently to the head and neck area could be elicited. The patient described sarcomas of the parotid gland are rhabdomyo- consulted a surgeon 5 months previously when the size of sarcoma and malignant fibrous histiocytoma (MFH), the swelling was 3 × 4 cm. Fine needle aspiration cytology although less commonly a variety of other tumors can (FNAC) was performed and the smears were suggestive occur, including leiomyosarcoma, malignant peripheral of spindle cell neoplasm. Subsequently, excisional biopsy nerve sheath tumor (MPNST), angiosarcoma, osteo- was advised, but the patient refused to undergo surgery. sarcoma, fibrosarcoma, liposarcoma, hemangiopericy- Local examination revealed a 9 × 8 cm, fungating mass in toma, Kaposi sarcoma synovial sarcoma, and alveolar the right preauricular region with an irregular, nodular surface, slightly tender to touch, firm to hard in consisten- cy, immobile and fixed to the underlying tissue. Cervical 1Senior Resident, 2Professor, 3,4Resident lymphadenopathy was absent and no sign of facial nerve 1-3Department of Pathology, Jawaharlal Nehru Medical College involvement was seen. Fine needle aspiration cytology Aligarh, Uttar Pradesh, India smears were reviewed and cytology revealed a highly cel- 4Department of Maxillofacial Surgery, Sir Ziauddin Dental College lular smear with relatively monomorphic spindle-shaped Aligarh, Uttar Pradesh, India cells with hyperchromatic, fusiform and tapering nuclei Corresponding Author: Shagufta Qadri, Senior Resident with scanty, elongated and poorly delimited cytoplasm Department of Pathology, Jawaharlal Nehru Medical College enmeshed with stromal element (Fig. 1). Aligarh, Uttar Pradesh, India, Phone: 919897532879, e-mail: Computed tomography (CT) scan revealed a hypoatte- [email protected] nuated mass measuring 9 × 8 cm, with ill-defined margins International Journal of Head and Neck Surgery, April-June 2015;6(2):99-102 99 Shagufta Qadri et al arising from right parotid gland along with the involve- carcinosarcoma (malignant mixed tumor) and MPNST ment of bone (Fig. 2). respectively, which led to the diagnosis of fibrosarcoma. Patient underwent a near total parotidectomy sparing Postoperative period was uneventful. Currently, the the facial nerve and the resected specimen was submitted patient is in follow-up. He is doing well 15 months after for histopathological examination. Gross examination surgery. showed an unencapsulated, nodular mass partially covered with skin showing surface ulceration and funga- DISCUSSION tion. Areas of hemorrhage and necrosis were also noted Tumors of salivary gland originate a diverse group of (Fig. 3). Cut-section revealed greyish-white, firm nodular neoplasms, and they may present significant challenges areas with accompanying foci of hemorrhage and necrosis. in the diagnosis as well as in their management. These Extensive histopathological examination of the tumor, tumors are rare with an overall incidence in the Western revealed sweeping fascicles of neoplastic spindle cells world of approximately 2.5 to 3.0 cases per 100,000 per with moderate degree of pleomorphism that exhibited year.5 Malignant salivary gland tumors account for 0.5% frequent ‘herring bone’ pattern and entrapment of few of all malignancies and approximately 3 to 5% of all head non-neoplastic acini and ducts within the tumor (Fig. 4). and neck cancers.5,6 The most common age of presentation The tumor also revealed high mitotic activity (18/10 hpf) for malignant tumors is in the sixth or seventh decade of with frequent atypical forms (Fig. 5). Immunohisto- life.7, 8 Ionizing radiation has been suggested as a cause chemical analysis showed only vimentin positivity (Fig. 6) of salivary gland cancer but the etiology of most salivary while pancytokeratin (Fig. 7) and S-100 (Fig. 8) were gland cancers is still unknown.6, 7,9,10 Certain occupations negative, that helped in excluding the possibility of are thought to be associated with an increased risk for Fig. 1: Fine needle aspiration cytology smear showing high Fig. 2: Computed tomography showing an ill-defined mass cellularity with monomorphic spindle cell population (H&E: 400×) protruding from the right parotid gland Fig. 3: Gross appearance demonstrating an irregular, nodular, Fig. 4: Sweeping fascicles of mature spindle cells exhibiting fungating mass, partially covered with skin with surface frequent herringbone pattern and normal acini and ducts entrapped ulceration within the tumor (H&E: 100×) 100 IJHNS Fibrosarcoma developing in the Parotid Gland: An Unusual Presentation Fig. 5: Spindle-shaped cells with hyperchromatic, fusiform Fig. 6: Vimentin immunostaining showing cytoplasmic positivity nuclei with scanty, fibrillary cytoplasm and a high mitotic activity in the spindle cells (vimentin: 400×) (H&E: 400×) Fig. 7: Tumor cells showing negative immunostaining for Fig. 8: S100 negativity of the neoplastic spindle cells pancytokeratin (CK: 100×) (S100: 100×) salivary gland cancers including rubber products manu- an intermediate grade of prognosis and rare metastasis, facturing, asbestos mining, plumbing, and some types whereas adult fibrosarcoma is a diagnosis of exclusion of wood works.7 The majority of the malignant tumors with a profound metastasizing potential and grave of salivary glands are epithelial in origin, whereas non prognosis. Grossly, adult fibrosarcoma appears as a well epithelial tumors constitute less than 5%, of which nearly circumscribed mass with firm white to tan cut surface. 90% are benign.11 Microscopy shows compact spindle cells arranged in Primary sarcomas of the parotid are an even rarer short fascicles which split and merge, giving the appea- group of malignant salivary gland tumors arising from rance known as ‘herring bone’ pattern in a background the mesenchymal component of salivary gland and com- of variable collagenous stroma. The individual cells are prises only 0.3 to 1.5% of all salivary gland neoplasms.2 spindle to polygonal in shape with fibrillary eosinophilic The two most common type of primary sarcomas of cytoplasm and plump hyperchromatic nuclei. the salivary gland have been reported to be malignant Certain conditions should be ruled out before reaching schwannoma and fibrosarcoma.4 Involvement of the a diagnosis of fibrosarcoma of the parotid. Firstly, in order parotid salivary glands are more common than the sub- to rule out the possibility of metastatic sarcoma, four basic mandibular glands.4 The mean age of occurrence has criteria should be met are as follows: been reported to be 42 years for men and 38
Load more

Recommended publications
  • Glossary for Narrative Writing
    Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper
    [Show full text]
  • PROPOSED REGULATION of the STATE BOARD of HEALTH LCB File No. R057-16
    PROPOSED REGULATION OF THE STATE BOARD OF HEALTH LCB File No. R057-16 Section 1. Chapter 457 of NAC is hereby amended by adding thereto the following provision: 1. The Division may impose an administrative penalty of $5,000 against any person or organization who is responsible for reporting information on cancer who violates the provisions of NRS 457. 230 and 457.250. 2. The Division shall give notice in the manner set forth in NAC 439.345 before imposing any administrative penalty 3. Any person or organization upon whom the Division imposes an administrative penalty pursuant to this section may appeal the action pursuant to the procedures set forth in NAC 439.300 to 439. 395, inclusive. Section 2. NAC 457.010 is here by amended to read as follows: As used in NAC 457.010 to 457.150, inclusive, unless the context otherwise requires: 1. “Cancer” has the meaning ascribed to it in NRS 457.020. 2. “Division” means the Division of Public and Behavioral Health of the Department of Health and Human Services. 3. “Health care facility” has the meaning ascribed to it in NRS 457.020. 4. “[Malignant neoplasm” means a virulent or potentially virulent tumor, regardless of the tissue of origin. [4] “Medical laboratory” has the meaning ascribed to it in NRS 652.060. 5. “Neoplasm” means a virulent or potentially virulent tumor, regardless of the tissue of origin. 6. “[Physician] Provider of health care” means a [physician] provider of health care licensed pursuant to chapter [630 or 633] 629.031 of NRS. 7. “Registry” means the office in which the Chief Medical Officer conducts the program for reporting information on cancer and maintains records containing that information.
    [Show full text]
  • The Health-Related Quality of Life of Sarcoma Patients and Survivors In
    Cancers 2020, 12 S1 of S7 Supplementary Materials The Health-Related Quality of Life of Sarcoma Patients and Survivors in Germany—Cross-Sectional Results of A Nationwide Observational Study (PROSa) Martin Eichler, Leopold Hentschel, Stephan Richter, Peter Hohenberger, Bernd Kasper, Dimosthenis Andreou, Daniel Pink, Jens Jakob, Susanne Singer, Robert Grützmann, Stephen Fung, Eva Wardelmann, Karin Arndt, Vitali Heidt, Christine Hofbauer, Marius Fried, Verena I. Gaidzik, Karl Verpoort, Marit Ahrens, Jürgen Weitz, Klaus-Dieter Schaser, Martin Bornhäuser, Jochen Schmitt, Markus K. Schuler and the PROSa study group Includes Entities We included sarcomas according to the following WHO classification. - Fletcher CDM, World Health Organization, International Agency for Research on Cancer, editors. WHO classification of tumours of soft tissue and bone. 4th ed. Lyon: IARC Press; 2013. 468 p. (World Health Organization classification of tumours). - Kurman RJ, International Agency for Research on Cancer, World Health Organization, editors. WHO classification of tumours of female reproductive organs. 4th ed. Lyon: International Agency for Research on Cancer; 2014. 307 p. (World Health Organization classification of tumours). - Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part B: Prostate and Bladder Tumours. Eur Urol. 2016 Jul;70(1):106–19. - World Health Organization, Swerdlow SH, International Agency for Research on Cancer, editors. WHO classification of tumours of haematopoietic and lymphoid tissues: [... reflects the views of a working group that convened for an Editorial and Consensus Conference at the International Agency for Research on Cancer (IARC), Lyon, October 25 - 27, 2007]. 4. ed.
    [Show full text]
  • Homologous Type of Malignant Mixed Mullerian Tumor of the Uterus Presenting As a Cervical Mass
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector CASE REPORT Homologous Type of Malignant Mixed Mullerian Tumor of the Uterus Presenting as a Cervical Mass Umur Kuyumcuoğlu, Ahmet Kale* Department of Obstetrics and Gynecology, Dicle University Medical School, Diyarbakir, Turkey. Malignant mixed Mullerian tumors are composed of a mixture of sarcoma and carcinoma. The carcinomatous element is usually glandular, whereas the sarcomatous element may resemble normal endometrial stroma (homologous or so- called carcinosarcoma). Here, we present a homologous type of malignant mixed Mullerian tumor of the uterus that pre- sented as a cervical mass. We describe a 55-year-old patient who had a cervical mass arising from the uterus. We performed total abdominal hysterectomy and bilateral salpingo-oophorectomy and surgical staging (including (peritoneal washings, suspicious areas or peritoneal surfaces sampled, infracolic omental sampling, pelvic and paraaortic lymph node sampling, and appendectomy). Carcinosarcomas of the uterine cervix are extremely rare, and when a post- menopausal woman with a cervical mass is admitted to the gynecology clinic, the physician should keep in mind that the mass might be a carcinosarcoma. [J Chin Med Assoc 2009;72(10):533–535] Key Words: carcinosarcoma, cervical mass, malignant mixed Mullerian tumors Introduction and pelvic/paraaortic lymphadenectomy are optimal therapy for carcinosarcoma.1,2 Uterine sarcoma is a malignant tumor that arises from Here, we describe an interesting case of carcino- the smooth muscle or connective tissue of the uterus. sarcoma (homologous type of malignant mixed tumor Uterine sarcomas are rare neoplasms of the female of the uterus) that presented as a cervical mass.
    [Show full text]
  • Nationwide Incidence of Sarcomas and Connective Tissue Tumors of Intermediate Malignancy Over Four Years Using an Expert Pathology Review Network
    medRxiv preprint doi: https://doi.org/10.1101/2020.06.19.20135467; this version posted June 22, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. Nationwide incidence of sarcomas and connective tissue tumors of intermediate malignancy over four years using an expert pathology review network. Prof. Gonzague de Pinieux MD, PhD *1 , Marie Karanian-Philippe MD *2, Francois Le Loarer MD, PhD*3, Sophie Le Guellec MD4 , Sylvie Chabaud PhD2, Philippe Terrier MD 5, Corinne Bouvier MD,PhD6, Maxime Battistella MD,PhD 7, Agnès Neuville MD, PhD3 , Yves-Marie Robin MD 8, Jean- Francois Emile MD, PhD 9 , Anne Moreau MD 10, Frederique Larousserie MD, PhD 11, Agnes Leroux MD12 , Nathalie Stock MD 13, Marick Lae MD 14, Francoise Collin MD15, Nicolas Weinbreck MD16, Sebastien Aubert MD8, Florence Mishellany MD17, Céline Charon-Barra MD15, Sabrina Croce MD, PhD3, Laurent Doucet MD 18, Isabelle Quintin-Rouet MD18 , Marie-Christine Chateau MD19 , Celine Bazille MD20, Isabelle Valo MD21, Bruno Chetaille MD16, Nicolas Ortonne MD22, Anne Gomez-Brouchet MD, PhD4 , Philippe Rochaix MD4, Anne De Muret MD1, Jean-Pierre Ghnassia MD, PhD23 , Lenaig Mescam-Mancini MD 25, Nicolas Macagno MD6, Isabelle Birtwisle-Peyrottes MD26, Christophe Delfour MD19, Emilie Angot MD13, Isabelle Pommepuy MD2, Dominique Ranchere-Vince MD2, Claire Chemin- Airiau MSc2 , Myriam Jean-Denis MSc2, Yohan Fayet PhD2 , Jean-Baptiste Courrèges MSc3 , Nouria Mesli MSc3 , Juliane Berchoud MSc10 , Maud Toulmonde MD, PhD3, Prof.
    [Show full text]
  • 2. Cancer NOMENCLATURE HYSTOPATHOLOGY-STUDENTS
    Why it is important to give the right name to a CANCER disease understanding the pathology and/or histology of CANCER cancer helps you: • to make a correct diagnosis (fundamental Nomenclature - Histopathology step for a correct therapy) • to formulate a better research question (fundamental for studying the etiology, the molecular pathogenesis, and the progression of the disease) • to design novel targeted therapeutic strategies Cancer is not a single static state Neoplasia but a progression and mixture of phenotypic and genetic/epigenetic • Benign tumours : changes that proceed toward – Will remain localized – Cannot (by definition= DOES NOT) spread greater aggressive biological to distant sites behavior – Generally can be locally excised – Patient generally survives Mutation in Mutation in Increasing • Malignant tumours: gene A gene B,C, etc. chromosomal aneuploidy – Can invade and destroy adjacent structure – Can (and OFTEN DOES) spread to distant Normal Cell Increased Benign neoplasia Carcinoma proliferation sites – Cause death (if not treated ) Cancer Hystopathology Diagnosis Neoplasia • Biopsy • two basic components: • Fine-Needle aspiration (FNA) – Parechyma: made up of neoplastic cells • Exfoliative cytology (pap smear) – Stroma: made up of non -neoplastic, • Biochemical markers (PSA, CEA, Alpha- host -derived connective tissue and fetoprotein) blood vessels The parenchyma: The stroma: Determines the Carries the blood biological behavior of the supply tumor Provides support for From which the tumour the growth of the derives its name parenchyma 1. Principle of nomenclature NOMENCLATURE (1) Benign tumors Attaching the suffix “-oma” to the type of cell (glandular, muscular, stromal, etc) The most basic classification plus the organ: e.g., adenoma of thyroid. of human cancer is the More detail: organ or body location in The name of organ and derived tissue/ cell + morphologic character + oma which the cancer arises e.
    [Show full text]
  • The 2015 World Health Organization Classification of Lung Tumors: New Entities Since the 2004 Classification
    PATHOLOGICA 2018;110:39-67 GIPP (GRUPPO ITALIANO DI STUDIO DI PATOLOGIA PLEUROPOLMONARE) • REVIEW The 2015 World Health Organization Classification of lung tumors: new entities since the 2004 Classification M.C. MENGOLI1, F.R. LONGO2, F. FRAGGETTA2, A. CAVAZZA3, A. DUBINI4, G. ALÌ5, F. GUDDO6, E. GILIOLI7, G. BOGINA8, N. NANNINI9, F. BARBISAN10, N. DE ROSA11, G. FALCONIERI12, G. ROSSI13, P. GRAZIANO14 1 Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia; 2 Pathology Unit, Azienda Ospedaliera per l’Emergenza Cannizzaro Hospital, Catania, Italy; 3 Pathology Unit, Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy; 4 Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy; 5 Pathology Unit, University Hospital of Pisa, Italy; 6 Pathology Unit, Ospedale V. Cervello, Palermo, Italy; 7 Pathology Unit, University and Hospital Trust, Verona, Italy; 8 Pathology Unit, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy; 9 Department of Cardiothoracic and Vascular Sciences, University of Padova, Italy; 10 Pathology Unit, Ospedali Riuniti of Ancona, Italy; 11 Department of Oncology and Anatomic Pathology, Hospital Vincenzo Monaldi of Napoli, Italy; 12 Department of Pathology, Policlinico di Cattinara, University of Trieste, Italy; 13 Pathology Unit, Azienda USL Valle d’Aosta, Regional Hospital “Parini”, Aosta, Italy; 14 Pathology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy Key words NUT carcinoma • Angiomatoid fibrous histiocytoma • Myxoid sarcoma • PEComatous tumors • Epithelial-myoepithelial carcinoma Summary In the last few years different new pulmonary neoplastic cally and genetically characterized albeit not yet included in lesions have been recognised and some of them, namely NUT the 2015-WHO classification. carcinoma, PEComatous tumors, pneumocytic adenomyoepi- In the present paper we summarised the clinical, morphological, thelioma, pulmonary myxoid sarcoma, myoepithelial tumors/ immunohistochemical and molecular features of these new enti- carcinomas entered in the last 2015-WHO classification of ties.
    [Show full text]
  • New Jersey State Cancer Registry List of Reportable Diseases and Conditions Effective Date March 10, 2011; Revised March 2019
    New Jersey State Cancer Registry List of reportable diseases and conditions Effective date March 10, 2011; Revised March 2019 General Rules for Reportability (a) If a diagnosis includes any of the following words, every New Jersey health care facility, physician, dentist, other health care provider or independent clinical laboratory shall report the case to the Department in accordance with the provisions of N.J.A.C. 8:57A. Cancer; Carcinoma; Adenocarcinoma; Carcinoid tumor; Leukemia; Lymphoma; Malignant; and/or Sarcoma (b) Every New Jersey health care facility, physician, dentist, other health care provider or independent clinical laboratory shall report any case having a diagnosis listed at (g) below and which contains any of the following terms in the final diagnosis to the Department in accordance with the provisions of N.J.A.C. 8:57A. Apparent(ly); Appears; Compatible/Compatible with; Consistent with; Favors; Malignant appearing; Most likely; Presumed; Probable; Suspect(ed); Suspicious (for); and/or Typical (of) (c) Basal cell carcinomas and squamous cell carcinomas of the skin are NOT reportable, except when they are diagnosed in the labia, clitoris, vulva, prepuce, penis or scrotum. (d) Carcinoma in situ of the cervix and/or cervical squamous intraepithelial neoplasia III (CIN III) are NOT reportable. (e) Insofar as soft tissue tumors can arise in almost any body site, the primary site of the soft tissue tumor shall also be examined for any questionable neoplasm. NJSCR REPORTABILITY LIST – 2019 1 (f) If any uncertainty regarding the reporting of a particular case exists, the health care facility, physician, dentist, other health care provider or independent clinical laboratory shall contact the Department for guidance at (609) 633‐0500 or view information on the following website http://www.nj.gov/health/ces/njscr.shtml.
    [Show full text]
  • Oral Pathology Final Exam Review Table Tuanh Le & Enoch Ng, DDS
    Oral Pathology Final Exam Review Table TuAnh Le & Enoch Ng, DDS 2014 Bump under tongue: cementoblastoma (50% 1st molar) Ranula (remove lesion and feeding gland) dermoid cyst (neoplasm from 3 germ layers) (surgical removal) cystic teratoma, cyst of blandin nuhn (surgical removal down to muscle, recurrence likely) Multilocular radiolucency: mucoepidermoid carcinoma cherubism ameloblastoma Bump anterior of palate: KOT minor salivary gland tumor odontogenic myxoma nasopalatine duct cyst (surgical removal, rare recurrence) torus palatinus Mixed radiolucencies: 4 P’s (excise for biopsy; curette vigorously!) calcifying odontogenic (Gorlin) cyst o Pyogenic granuloma (vascular; granulation tissue) periapical cemento-osseous dysplasia (nothing) o Peripheral giant cell granuloma (purple-blue lesions) florid cemento-osseous dysplasia (nothing) o Peripheral ossifying fibroma (bone, cartilage/ ossifying material) focal cemento-osseous dysplasia (biopsy then do nothing) o Peripheral fibroma (fibrous ct) Kertocystic Odontogenic Tumor (KOT): unique histology of cyst lining! (see histo notes below); 3 important things: (1) high Multiple bumps on skin: recurrence rate (2) highly aggressive (3) related to Gorlin syndrome Nevoid basal cell carcinoma (Gorlin syndrome) Hyperparathyroidism: excess PTH found via lab test Neurofibromatosis (see notes below) (refer to derm MD, tell family members) mucoepidermoid carcinoma (mixture of mucus-producing and squamous epidermoid cells; most common minor salivary Nevus gland tumor) (get it out!)
    [Show full text]
  • A Practical Approach to Undifferentiated Tumors: a Review on Helpful Markers and Common Pitfalls
    Asian Archives of Pathology 2013; Vol. 9 No.4, 123-136 Special article A practical approach to undifferentiated tumors: A review on helpful markers and common pitfalls Kanapon Pradniwat, MD, Jitsupa Treetipsatit, MD Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University Corresponding author: Jitsupa Treetipsatit, MD Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok Noi, Bangkok 10700, Thailand Phone: 662-419-6520 Fax: 662-411-4260 E-mail address: [email protected] Received: 12 August 2013; Accepted 28 September 2013 ABSTRACT The term “undifferentiated” tumor is commonly used by pathologists when a tumor lacking evidence of lineage differentiation on the basis of routine light microscopic morphology is encountered. Immunohisto- chemistry plays an important role in elucidating the true nature of the undifferentiated tumor that is crucial for clinical management. Since undifferentiated round cell tumors can be mimicked by different types of tumors and often cause diagnostic problems especially in small biopsy specimen, the aim of this review is to provide a practical approach to select helpful immunohistochemical markers, a proposed algorithmic approach and pitfalls that may encountered. Keywords: Undifferentiated tumors, Round cell tumors INTRODUCTION be put in consideration. This article is aimed to Pathologists usually use the term “undif- provide: 1) a concise review on general approach for ferentiated” tumor when a tumor lacks histologic undifferentiated tumors as well as markers that are features which specify its lineage of differentiation. parts of the screening panels used in the recognition However, among these undifferentiated tumors, of the major lineages of the tumor; 2) a proposed a large proportion of cases can be delineated by algorithmic approach using immunohistochemistry; ancillary techniques namely immunohistochemistry.
    [Show full text]
  • Adverse Effects of Medicinal and Non-Medicinal Substances
    Benign? Not So Fast: Challenging Oral Diseases presented with DDX June 21st 2018 Dolphine Oda [email protected] Tel (206) 616-4748 COURSE OUTLINE: Five Topics: 1. Oral squamous cell carcinoma (SCC)-Variability in Etiology 2. Oral Ulcers: Spectrum of Diseases 3. Oral Swellings: Single & Multiple 4. Radiolucent Jaw Lesions: From Benign to Metastatic 5. Radiopaque Jaw Lesions: Benign & Other Oral SCC: Tobacco-Associated White lesions 1. Frictional white patches a. Tongue chewing b. Others 2. Contact white patches 3. Smoker’s white patches a. Smokeless tobacco b. Cigarette smoking 4. Idiopathic white patches Red, Speckled lesions 5. Erythroplakia 6. Georgraphic tongue 7. Median rhomboid glossitis Deep Single ulcers 8. Traumatic ulcer -TUGSE 9. Infectious Disease 10. Necrotizing sialometaplasia Oral Squamous Cell Carcinoma: Tobacco-associated If you suspect that a lesion is malignant, refer to an oral surgeon for a biopsy. It is the most common type of oral SCC, which accounts for over 75% of all malignant neoplasms of the oral cavity. Clinically, it is more common in men over 55 years of age, heavy smokers and heavy drinkers, more in males especially black males. However, it has been described in young white males, under the age of fifty non-smokers and non-drinkers. The latter group constitutes less than 5% of the patients and their SCCs tend to be in the posterior mouth (oropharynx and tosillar area) associated with HPV infection especially HPV type 16. The most common sites for the tobacco-associated are the lateral and ventral tongue, followed by the floor of mouth and soft palate area.
    [Show full text]
  • Table of Contents
    CONTENTS 1. Specimen evaluation 1 Specimen Type. 1 Clinical History. 1 Radiologic Correlation . 1 Special Studies . 1 Immunohistochemistry . 2 Electron Microscopy. 2 Genetics. 3 Recognizing Non-Soft Tissue Tumors. 3 Grading and Prognostication of Sarcomas. 3 Management of Specimen and Reporting. 4 2. Nonmalignant Fibroblastic and Myofibroblastic Tumors and Tumor-Like Lesions . 7 Nodular Fasciitis . 7 Proliferative Fasciitis and Myositis . 12 Ischemic Fasciitis . 18 Fibroma of Tendon Sheath. 21 Nuchal-Type Fibroma . 24 Gardner-Associated Fibroma. 27 Desmoplastic Fibroblastoma. 27 Elastofibroma. 34 Pleomorphic Fibroma of Skin. 39 Intranodal (Palisaded) Myofibroblastoma. 39 Other Fibroma Variants and Fibrous Proliferations . 44 Calcifying Fibrous (Pseudo)Tumor . 47 Juvenile Hyaline Fibromatosis. 52 Fibromatosis Colli. 54 Infantile Digital Fibroma/Fibromatosis. 58 Calcifying Aponeurotic Fibroma. 63 Fibrous Hamartoma of Infancy . 65 Myofibroma/Myofibromatosis . 69 Palmar/Plantar Fibromatosis. 80 Lipofibromatosis. 85 Diffuse Infantile Fibromatosis. 90 Desmoid-Type Fibromatosis . 92 Benign Fibrous Histiocytoma (Dermatofibroma). 98 xi Tumors of the Soft Tissues Non-neural Granular Cell Tumor. 104 Neurothekeoma . 104 Plexiform Fibrohistiocytic Tumor. 110 Superficial Acral Fibromyxoma . 113 Superficial Angiomyxoma (Cutaneous Myxoma). 118 Intramuscular Myxoma. 125 Juxta-articular Myxoma. 128 Aggressive Angiomyxoma . 128 Angiomyofibroblastoma. 135 Cellular Angiofibroma. 136 3. Fibroblastic/Myofibroblastic Neoplasms with Variable Biologic Potential.
    [Show full text]