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 Dr Sampurna Roy MD

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http://www.histopathology-india.net/SoftTissuePath.htm

August 2009

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E-book - History of  Medicine with special reference to India.

Basic Pathology Blog

Myxoid Tumours of Soft Tissue

Classification of Soft Tissue Tumour

Gross examination of soft tissue specimen          

A practical approach to histopathological reporting of soft tissue tumours

Grading of soft tissue tumours

Lipomatous tumours

Neural tumours

Myogenic tumours

Fibroblastic/Myofibroblastic tumours

Myofibroblastic tumours

Fibrohistiocytic tumours

ChondroOsseous tumours

Soft TissueTumours of Uncertain Differentiation               

Notochordal Tumour - Chordoma

Extra-adrenal Paraganglioma

Gastrointestinal Stromal Tumour

Intramuscular Myxoma

Aggressive Angiomyxoma

Ossifying fibromyxoid tumour

Synovial Sarcoma

Alveolar Soft Part Sarcoma

Epithelioid Sarcoma

Clear cell sarcoma & PEComas

Desmoplastic small round cell tumour

Pleomorphic hyalinizing angiectatic tumour

Mixed tumour, myoepithelioma, parachordoma

Ectopic hamartomatous thymoma

Extra-renal rhabdoid tumour

Malignant mesenchymoma

      

 Classification of Cutaneous Meningeal Lesion:

1.  Ectopic meningothelial hamartoma :

Site: Scalp (occipital region)  and spinal cord

Clinical presentation: Congenital lesion. Presents as cutaneous lump in children. No true defect of skull or spinal column is present.
 

Microscopic features:  

Image Link1: click ; Image Link2: click

- Lesion is characterized by narrow ectatic pseudovascular spaces lined by epithelioid meningothelial cells present in the dermis and subcutis.  Immunohistochemically , these cells were negative for factor VIII-related antigen and Ulex europaeus lectin but were strongly positive with vimentin and epithelial membrane antigen antibodies, this latter being in keeping with the immunohistochemical profile of meningothelial cells.

- Abnormally dense collagen is present in the backround.

- Irregular strands and clusters of meningothelial cells and variable numbers of psammoma bodies may be present in the collagenous stroma.

- Scattered multinucleate cells may be present.
     
2.  Cutaneous meningioma :

Site: Around sensory organs of the head -Eg. paranasal, orbital and aural.

Clinical presentation: Presents as a discrete nodule in adults.

Microscopic features:
The tumour  is  well circumscribed and more cellular. It is composed of meningothelial cells together with spindle cell areas.  Psammoma bodies and meningeal whorls may be present.

3. Type III lesion :

This lesion represents direct extension or distant metastasis of central nervous system meningioma. The tumour spreads into the skin and subcutaneous tissue usually at the site of previous surgery.

Immunohistochemistry: S100 protein, EMA and Vimentin are positive.

            

Abstracts:

The pathology of extracranial scalp and skull masses in young children.
Clin Neuropathol. 2004 Jan-Feb;23(1):34-43.

Primary ectopic meningioma.J Indian Med Assoc. 2001 Feb;99(2):102-3, 110.

Type 1-primary cutaneous meningioma of the scalp.Eur J Pediatr Surg. 2000 Dec;10(6):387-9.

Meningeal hamartoma of the scalp. A variant of primary cutaneous meningioma.Acta Pathol Jpn.1992;42(5):353-7.

Hamartoma of the scalp with ectopic meningothelial elements. A distinctive benign soft tissue lesion that may simulate angiosarcoma.Am J Surg Pathol. 1990 Jan;14(1):1-11.

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Pathopedia-India.com:

Contents ; Introduction of Pathology ; An outline of Diagnostic Techniques available in Pathology ; Cellular Injury ; Diagram showing Structural Changes in Reversible and Irreversible Cell Injury ; Autolysis; Heterolysis ; Necrosis; Coagulation (Coagulative) necrosis ; Caseative (Caseous) necrosis ; Liquefaction necrosis ; Fat necrosis ; Fibrinoid necrosis ; Apoptosis ; Gangrene ; Hyaline Change ; Atrophy ; Hypertrophy ; Hyperplasia ; Metaplasia ; Aplasia ; Hypoplasia ;Cellular Accumulations ; Accumulation of Glycogen, complex lipids and carbohydrates ; Pigments ; Melanin ; Pigments derived from Hemoproteins; Hemosiderin and Hemosiderosis ; Primary Hemochromatosis ; Hematin; Bilirubin.

Reactive and hamartomatous lesions:

Traumatic neuroma

Morton's neuroma

Digital Pacinian neuroma

Nerve Sheath Ganglion

Fibrolipomatous hamartoma of nerve

Benign tumours:

Solitary circumscribed neuroma
(palisaded encapsulated neuroma)

Schwannoma (neurilemmoma)
and variants                          

Neurofibroma and variants 

Perineurioma   

Dermal nerve sheath myxoma
(neurothekeoma)

Cellular neurothekeoma

Granular cell tumour

              
Malignant tumour:

Malignant peripheral nerve sheath tumour
  


Neuroendocrine Carcinoma:

Merkel cell (neuroendocrine) carcinoma

Malignant primitive neuroectodermal tumour   

Miscellaneous neuroectodermal tumours presenting in soft tissue

Subcutaneous Myxopapillary Ependymoma  

Heterotopic Glial Nodule

Heterotopic Meningeal Lesions

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MESOTHELIOMA OF ATRIOVENTRICULAR NODE

PURKINJE CELL TUMOUR

CARDIAC PARAGANGLIOMA

MALIGNANT TUMOURS OF THE HEART

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