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MESENCHYMAL TUMORS - Coggle Diagram

- - - - Routine staining = H&E + immunohistochemistry + molecular biology (increasing importance) --> Detection of translocations / gene rearrangement, Point mutations & ELMI
      - MORPHOLOGY
        
        Spindle
        
        Round
        
        Epitheloid
        
        Pleomorphic
        
        Fasicular
        
        Herringbone
        
        Storiform
        
        Arcades
        
        Arborizing
        
        Staghorn
      - IH: AE1/AE3, EMA, desmin, SMA, S-100, CD34
- - - - Painless; can be bulky
        macro i micro: - mature fat tissue
    - - Bulky (more than 20 cm) most frequently, leg and retroperitoneum
      - Variants: differentiated, dedifferentiated, myxoid/round-cell, pleomorphic
      - micro: lipoblasts + atypical cells
    - - Og: Brown AT
        
        Loc: shoulder, neck in younger people
        
        Benign
        
        Composed of foamy, eosinophilic and mitochondria-rich cells filled by phospholipids
  - - - HEMANGIOMA: common, loc: head and neck, big nodules made of dilated vessels filled with blood, looking blue to red. Cause: Malformations True tumor, Sinusoidal mayhem (abnormal flow eg Liver sinusoids) , Reactive processes.... Can be decided to type of vessel: capillary, cavernous, mixed or type of endothelial cell: Epithelia, sinusoid, granulomatoid. Macro: blue noted, large lesions
      - LYMPHANGIOMA: Head & neck cystic hygroma– Turner syndrome), In other regions (often skin and mesentery) rather cavernous
      - KAPOSI SARCOMA: HHV8
        
        locally aggressive, skin lesions, can affect parenchymal organs (lungs, liver)
        
        Spindle cells + fibrosis + „capillary“
      - EPITHELIOID HEMANGIOENDOTHELIOMA: low mts potential, 20% mortal, recall mts mucinous adenoCa – vacuolated cells in hyalinized stroma
    - - ANGIOSARCOMA:
        
        1ª is rare
        
        2ª changed terrain: previous actinotherapy (>10y) or chronic lymphedema (Stewart-Treves Syn)
        
        Skin lesions, in soft tissue and parenchymal organs (liver, lung, breast..). Mts: lungs
        
        Very malignant, aggressive. w/ reminiscent vessels, bleeding, necrosis, IC lumina, very polymorphic & complicated dg. (IHC)
  - - - RHABDOMYOMA: cardial, rarely extracardial (head&neck, urogenital tract)
    - - RHABDOMYOSARCOMA: Very aggressive , early mts to Lung Primitive cells – rhabdomyoblasts w/ Striated appearance of cytoplasm
        „strap“, „spider“, „racket“ cells & „lymphoid“ cells.
        1) embryonal & 2) alveolar (PAX3)--> children/puberty, head&neck & urogenital 3) Pleomorphoc -> adults
  - - - LEIOMYOMA: skin, uterus, LL, retrop., GIT
    - - LEIOMYOSARCOMA: Elongated spindle cells w/ cigar shaped ncl, in crossing bundles. Retrop., vessels, deep T.