Soft Tissue Pathology for Clinicians

1 Critical Concepts in Soft Tissue Pathology 1
1.1 General Principles of Classification 1
1.2 Acquisition, Handling, and Processing of Soft
Tissue Specimens 4
References 6
2 Histologic Examination and Ancillary Studies in Soft
Tissue Pathology 7
2.1 Pathologist Approach to Diagnosis 7
2.2 Diagnostic Ancillary Studies 15
2.2.1 Immunohistochemistry 15
2.2.2 Karyotyping 15
2.2.3 Molecular Fluorescence In Situ Hybridization 18
2.2.4 Reverse transcription PCR 18
2.3 Intraoperative Consultation 18
References 21
3 Grading, Staging, and Reporting of Soft Tissue Tumors 23
3.1 Assigning a Pathologic Grade to Soft Tissue Tumors 23
3.2 Assigning a Pathologic Stage to Soft Tissue Tumors 25
3.3 Interpreting a Soft Tissue Pathology Report 25
References 28
4 Lipomatous Tumors 29
4.1 Lipoma 29
4.2 Angiolipoma 31
4.3 Spindle Cell/Pleomorphic Lipoma 33
4.4 Hibernoma 35
4.5 Lipoblastoma 36
4.6 Atypical Lipomatous Tumor/Well-Differentiated
Liposarcoma 37
4.7 Dedifferentiated Liposarcoma 40
4.8 Myxoid Liposarcoma 41
4.9 Pleomorphic Liposarcoma 43
References 45
5 Fibroblastic/Myofibroblastic Tumors 49
5.1 Nodular Fasciitis and Similar Lesions 49
5.2 Fibroma of Tendon Sheath 53
5.3 Nuchal-Type Fibroma 54
5.4 Gardner-Associated Fibroma 56
5.5 Elastofibroma 57
5.6 Superficial Fibromatosis 59
5.7 Deep (Desmoid-Type) Fibromatosis 60
5.8 Solitary Fibrous Tumor 62
5.9 Inflammatory Myofibroblastic Tumor 65
5.10 Dermatofibrosarcoma Protuberans 67
5.11 Congenital/Infantile Fibrosarcoma 70
5.12 Low-Grade Fibromyxoid Sarcoma 71
5.13 Myxofibrosarcoma 74
5.14 Adult-Type Fibrosarcoma 76
References 78
6 Fibrohistiocytic Lesions 81
6.1 Fibrous Histiocytoma 81
6.2 Solitary Xanthogranuloma 85
6.3 Tenosynovial Giant Cell Tumor, Localized Type
6.4 Tenosynovial Giant Cell Tumor, Diffuse Type 89
References 91
7 Smooth Muscle and Perivascular Tumors 93
7.1 Glomus Tumor 93
7.2 Cutaneous Leiomyoma 97
7.3 Deep Leiomyoma 99
7.4 Cutaneous Leiomyosarcoma 101
7.5 Deep Leiomyosarcoma 103
References 106
8 Skeletal Muscle Tumors 109
8.1 Rhabdomyoma 109
8.2 Embryonal Rhabdomyosarcoma
8.3 Alveolar Rhabdomyosarcoma 115
8.4 Pleomorphic Rhabdomyosarcoma 118
References121
9 Neural and Nerve Sheath Lesions 123
9.1 Schwannoma 123
9.2 Neurofibroma 126
9.3 Perineurioma 130
9.4 Granular Cell Tumor 133
9.5 Malignant Peripheral Nerve Sheath Tumor 135
References 138
10 Vascular Lesions 139
10.1 Kaposi Sarcoma 139
10.2 Epithelioid Hemangioendothelioma 143
10.3 Kaposiform Hemangioendothelioma 145
10.4 Angiosarcoma 148
References 152
11 Cartilaginous and Osseous Tumors of Soft Tissue 155
11.1 Extraskeletal Chondroma155
11.2 Extraskeletal Mesenchymal Chondrosarcoma 158
11.3 Extraskeletal Osteosarcoma160
References 162
12 Tumors of Uncertain Differentiation 163
12.1 Intramuscular Myxoma 163
12.2 Superficial Angiomyxoma 165
12.3 Hemosiderotic Fibrolipomatous Tumor 167
12.4 Myoepithelioma of Soft Tissue169
12.5 Ossifying Fibromyxoid Tumor 171
12.6 Alveolar Soft Part Sarcoma 173
12.7 Clear Cell Sarcoma of Soft Tissue175
12.8 Extraskeletal Ewing Sarcoma
12.9 Desmoplastic Small Round Cell Tumor 179
12.10 PEComa (and Similar Neoplasms) 180
12.11 Epithelioid Sarcoma182
12.12 Extrarenal Rhabdoid Tumor 185
12.13 Synovial Sarcoma 186
12.14 Extraskeletal Myxoid Chondrosarcoma 188
12.15 Undifferentiated High-Grade Pleomorphic Sarcoma 190
References 192
13 Gastrointestinal Stromal Tumor 197
13.1 Introduction 197
13.2 Gastrointestinal Stromal Tumor 197
References 201

Index203