* Formatives: tumor like growths of fibrous tissue in the soft tissue, e. g. dermatofibroma, nodular facilities, juvenile aponeurotic fibroma, desmoid fibromatosis, keloid, and palmar fibromatosis
(2) Lipoma Gross: lobulated mass with thin capsule, greasy on cut surface, yellowish in color. Histological: composed of mature fat cells. Site: Commonly in the subcutaneous tissue of arms, shoulder, and buttocks
(3) Hemangioma Usually congenital but may be acquired. Gross: Portwine colored, soft, poorly defined lesion Histological: Composed of blood vessels, invasive growth partner. Type: ① Capillary type commonly in skin or mucous membrane ② Cavernous type commonly in skin, spleen, liver.
(2) Rhabdomyosarcoma Type: ① Embryonal rhabdomyosarcoma: Most common type occurs in children often arise in the nasal cavity, orbit, middle ear, prostate, and Para testicular region. Various stages of embryogenesis round and spindled cells in a variably myxoid stroma.
② Alveolar rhabdomyosarcoma Occur in early to mid adolescence Commonly arise in the deep musculature of extremities pulmonary alveolae like. ③ Pleomorphic rhabdomyosarcoma Numerous large, multinucleated, bizarre eosinophilic tumor cells
(3) Osteosarcoma A highly malignant tumor of bone Infiltrative growth manner both into the marrows and outwards into the surrounding soft tissue. Formatting tumor osteoid by the tumor cells. Some characteristics: “ sunburst ” appearance, codman ’ s triangle
Osteosarcoma (Quoted from Robbins 《 Pathology Basis of disease 》 )
(4) Liposarcoma Commonly occur in the buttocks, lower limbs, retroperitoneum. Composed of embryonic fat cells containing small fat globules in cytoplasm.
大腿脂肪肉瘤 A 手术前外观 B CT 影象 C 手术切除标本 D 镜下 ( 由宋建新主任医师提供 )
(6) Kaposi 肉瘤 Quoted from Robbins Basic Pathology, 2003
(7) Malignant fibrous histiocytoma Refer to a heterogeneous group of aggressive soft tissue tumors characterized by considerable cytologist plemorphism. Spindled cells in swirling (storiform) pattern. (8) Malignant lymphoma (9) Leukemia
3. Comparisons Between Carcinoma and Sarcoma CarcinomaSarcoma ① Histogenesis Epithelial tissuesMesenchymal tissues ② Morbidity High. In older ageLow. In children & young ③ Gross Hard, gray-white, drySoft, fleshy ④ Histologicaly Form carcinoma nests, so, there are clear line of demark- ation between nests & sup- ortive stroma. Tumor cells diffuse in supportive stroma, so, there are not marked boundary between parenchyma & supportive stroma.
CarcinomaSarcoma ⑤ Reticular fiber Staining: Around carcinoma nest,no around tumor cells. Around tumor cells ⑥ Metastasis: Most frequently via lymphatics. Most frequently via blood vessels.
1. The central nervous tumors (1) Glioma ① Astrocytoma ② Oligodendroglioma ③ Ependymoma (2) Medulloblastoma (3) Meningioma
4. Pigmented nevus and melanoma (1) Pigmented nevus Most authorities agree that the melanocytes are derived from neuro- ectoderm, and migrate to the basal layer of the skin in early intrauterine life A nevus or more implies a benign pigmented tumor containing nevus cells.
(2) Melanoma Malignant Gross: a variably pigmented, rapidly rowing, Ulcerated and bleeding lesion of the skin Histological: Pleomorphic, melanin- containing cellsinvading the underlying tissues. Amelanotic melanoma: Someone have no melaning pigment, but still DOPA positive.