131/surrounding the distal femur was a 13.0 x 12.0 x 5.0 em tumor involving the anterior, medial and...

. .. ~

CALIFORNIA TUMOR TISSUE REGISTRY

California Tumor Tissue Registry do: Department of Pathology and Boman Anatomy

Loma Linda University School of Medicine I 1021 Campus Avenue, AB 335 Loma Linda, California 92350

(909) 824-4788 FAJ(: (909) 478-4188

E-mail: [email protected]

131/

Target audience: Practicing pathologists and pathology residents.

Goal: To acquaint the participant with the histologic features of a variety of benign and malignant neoplasms and tumor-like conditions.

Objective: The participant will be able to recognize morphologic features of a variety of benign and malignant neoplasms and tumor-like conditions and relate those processes to pertinent references in the medical literature.

Educational methods and media: Review of representative glass slides with associated histories.

• Feedback on consensus diagnoses from participating pathologists. Listing of selected references from the medical literature.

Principal facultv: Weldon K. Bullock, MD Donald R. Chase, MD

CME Credit: The Lorna Linda University School of Medicine, designate this Continuing medical education activity for up to 2 hours of Category l Of the Physician's Recognition Award of the American Medical Association.

Accreditation: The California Tumor Tissue Registry, under the Lorna Linda University School of Medicine, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor Medical education for Physicians.

CONTRIBUTOR: Philip G. Robinson, M.D. CASE NO.1 - SEPTEMBER 1998 Boynton Beach, FL

TISSUE FROM : Liver ACCESSION #28272

CLINICAL ABSTRACT: This 62-year-old male was found to have a rising CEA and work-up revealed a 10.0 x 12.0 em

hepatic mass. The patient underwent resection of the left hepatic lobe.

GROSS PATHOLOGY: The 495 gram, I 2.5 x I 2.2 x 6.0 em portion of liver was almost completely replaced by a large,

spongy red nodule.

CONTRIBUTOR: Morteza Moussa vi, M.D. El Centro, CA

TISSUE FROM: Left tbigb

CLINICAL ABSTRACT:

CASE NO. 2 -SEPTEMBER 1998

ACCESSION #28186

This 47-year-old Caucasian male presented with a 5.0 em diameter mass in the left anterior thigh. He bad had a benign hemangioma removed from the axilla 25 years earlier.

GROSS .PATHOLOGY: The specimen consisted of a 9.5 x 4.0 x 2.5 em ellipse oftan skin with a 1.0 x 0.8 x 0.4 em

;::pidennal nodule and a 3.5 em subcutaneous nodule.

JSPECLAL STUDIES: CD-34 positive

CONTRIBUTOR: Wafa Michae~ M.D. CASE NO. 3 - SEPTEMBER 1998 Fontana, CA

TISSUE FROM: Retroperitoneal ACCESSION #28390

CLINICAL ABSTRACT: This 61-year-old woman was found to have a retroperitoneal mass, which was excised

GROSS PATHOLOGY: The I 00 gram, 8.0 x 5.0 x 5.5 em specimen consisted of lobulated tan-pink-yellow soft tissue

which had a rubbery consistency. Cut sectioning revealed areas of extensive fat necrosis, and the remainder exhibited myxomatous change.

CONTRIBUTOR: Robert E. Jordan, M.D. CASE NO. 4 - SEPTEMBER 1998 Ventura, CA

TISSUE FROM: Neck ACCESSION #28332

CLINICAL ABSTRACT: This man presented with a futty tumor of the neck.

GROSS PATHOLOGY: The specirilen consisted of a fatty fibrous tissue mass, which measured 2.5 x 2.0 x 1.6 em.

SPECIAL STUDIES: CD-34 positive (in spindled cells)

CONTRIDUTOR: Mark Janssen, M.D. CASE NO. 5 - SEPTEMBER 1998 Anaheim, CA

TISSUE FROM: Left inner thigh ACCESSION #28094

CLINICAL ABSTRACT: This is a 64-year-old Caucasian male presented with a mass in the inner thigh that had been

slowly growing over several years. The mass was excised due to its increased size.

GROSS PATHOLOGY: The specimen consisted of a 3.5 x 3.0 x 2.5 em portion of irregular-shaped pink-yellow

fibrofutty tissue. Cut surfuces were varieg!lted tan-yellow without evidence of hemorrhage or necrosis.

CONTRIBUTOR: Ellen Ko, M.D. CASE NO. 6 - SEPTEMBER 1998 Sylmar, CA

TISSUE FROM: Thigh ACCESSION #28261

CLINICAL ABSTRACT: This 31-year-old female presented with a mass in the right thigh. She had a past history for

multiple neurofibromas.

GROSS PATHOLOGY: The 13.0 x 6.0 x 6.0 em specimen consisted of skin, subcutaneous tissue and underlying

muscle. Cut surfuce revealed a 5.0 em diameter well-circumscribed tumor composed of myxoid light tan tissue. There were focal areas suggestive of necrosis.

CONTRIBUTOR: E. DuBose Dent, Jr., M.D. CASE NO.7 - SEPTEMBER 1998 Glendale, CA

TISSUE FROM: Right kidney ACCESSION #24520

CLINICAL ABSTRACT: This 84-year-old Caucasian male presented with a large mass at the inferior pole of the right

kidney.

GROSS PATHOLOGY: The 1225 gram, 22.0 x 12.0 x 8.0 em kidney had a 13 em diameter mass projecting from the

inferior pole, and was still bounded by the renal capsule. The mass varied from soft to firm in consistency and had a variegated pale gray-white to yellow-brown to red-brown appearance.

SPECIAL STUDIES: HHF-35 Keratin cocktail CAM5.2 Des min S-100

mildly positive (I+ out of3+) negative negative focally positive (in spindled cells) negative

CONTRIBUTOR: Lorna Linda Pathology Group (bl) CASE NO.8 - SEPTEMBER 1998 LomaLinda

TISSUE FROM: Left leg ACCESSION #28416

CLINICAL ABSTRACT: This 31-year-old male presented with a tumor involving the left femur.

GROSS PATHOLOGY: The 7300 gram left leg was disarticulated at the hip. Surrounding the distal femur was a 13.0 x

12.0 x 5.0 em tumor involving the anterior, medial and lateral compartments. The tumor eroded into the portions of the distal femur and showed gross invasion of the skeletal muscle. The tumor was soft and composed of variegated tan, brown and yellow tissue with a faintly nodular pattern.

SPECIAL STUDIES: Desmin trace positive Smooth musele aetin 2 + (out of3+))

CALIFORNIA TUMOR TISSUE REGISTRY

SOFT TISSUE TUMOR PATHOLOGY

Minutes -Subscription B

September 1998

SUGGESTED READING (General Topics from Recent Literature):

Application of Immunocytochemistry in the Diagnosis of Soft Tissue Sarcomas. A Review and Update. Adv in Anatomic Parlrol 1998; 5(2):61-85. Ordonez, NG.

News in Brief. Mclanocytes Found for the First Time in a Major Salivary Gland. Adv in Anatomic Pathol 1998; 5(2): 115.

News in Brief. A Novel, lf Not Exciting, Way to Look at Tumor Suppressor Gene.s. A Great Read! Adv in Anatomic Parho/1998; 5(2): 124.

Do "Rhabdoid fentures" lmpart a Poorer Prognosis to Promixni-Type Epithelioid Sarcomas? Adv in Anatomic Parhol 1997; 4(5):293-299. Chase, DR.

The Emerging Molecular Genetics of Sarcomn Translocation~ Dlagn Mol Par hoi 1995; 4: 162- 173. LadanyiM.

Smalllntestinal Stromal Tumors. A Clinicopathologic Study of 20 Cases With Immunohistochemical Assessment of Cell Differentiation and the Prognostic Role of Proliferation Antigens. Anatomic Pathol 1997; 108(6):641-651.

California Tumor Tissue Registry c/o: Department of Pathology and Human Anatomy

Lorna Linda University School of Medicine I 1021 Campus Avenue, AH 335 Lorna Linda, California 92350

(909) 824-4788 FAX: (909) 478-4188

E-mail: [email protected]

CASE NO. 1 ACCESSION NO. 28272

CALlFORNIA (Glendale) • Cavernous hemangioma

ARIZONA <Phoenix) • Hemangioma

UTAH (Salt Lake Citv) • Cavernous hemangioma

OKLAHOMA (Ardmore) . Benign hemangioma of liver

MICH1GAN <Royal Oak) · Spindle cell hemangioendothelioma

MICIDGAN !Ann Arbor) · Cavernous hemangioma

INDIANA CFort Wayne) • Cavernous hemangioma, liver

KENTUCKY (Ft Knox) • Hepatic hemangioma

ILLINOlS (Park Ridge) • Angiosarcoma

FLORrDA (Miami) • Cavernous hemangioma

FLORIDA (Winter Haven) . Hemangioma

LOUISIANNA (Metairie) . Cavernous hemangioma

NEW JERSEY (Short Hills) · Angiosarcoma

PENNSYLVANIA (Philadelphia) • Peliosis hepatica and hemangioma

MASSACHUSEITS (Medfield) • Peliosis hepatis

DIAGNOSIS:

CAVERNOUS HEMANGIOMA, LIVER

REFERENCES:

Hobbs K. Hepatic Hemangiomas. Wor/dJSurg 1990; 14:468-471.

SEPTEMBER 1998

TS(iOOO, M91200

Stanley P, Oeer G, Mi ller J, et al. Infantile Hepatic Hemangiomas. Clinical Features, Radiologic Investigations, and Treatment ol201'atients. Cancer 1989; 64:936-949.

l'watsuki S, Todo S, and Starzl TE. Excisional Therapy of Benign Hepatic Lesions. Surg Gynecol Obstet 1990; I 71:240·246. (Includes Hemangiomas).

Johnson CM, Sheedy II Pf, Stanson AW, et al. Computed Tomography and Angiography of Cavernous Hemangiomas of the Liver. Radiology 1981; 138: 115-121.

Koj imahara M. Ultrastructural Study of Hemangiomas 4. Cavernous Hemangioma of the Liver. Acta Pathol 1986 (Japan). 36:1477-1485.


CALIFORNIA CGiendale) - Dermatofibrosarcoma protubcmns

ARIZONA (Phoenix) - Fibromatosis (extra-abdominal desmoid)

UTAH (Salt Lake Citv) - Dermatofibrosarcoma prorubcrans

OKLAHOMA (Ardmore) . Dermatofibrosarcoma protubcro.ns

MICHIGAN CRoyal Oak) · Dermatofibrosarcoma protubcrans

MICHIGAN (Ann Arbor) · Dermatofibrosarcoma protuberans

INDIANA (Fort Wayne) • Dermatofibrosarcoma protuberans

SEPTEMBER 1998

KENTUCKY CFt. Knox) • Dennatofibrosarcoma proruberans- check other areas to rule out fibrosarcoma changes

ILLINOIS (Park Rjdge) - Hemangiopcricytoma

FLORIDA CMinmD - Dermatofibrosarcoma proruberans

FLORIDA (Winter Haven) - Desmoid, fibromatosis

LOUISIANNA (Metairie) - Dermatofibrosarcoma protuberans

NEW JERSEY (Short Hills) • Dcnnatofibrosarcoma protubcrans

PENNSYLVANIA (Philadelphia) • Dennatofibrosarcoma protubcrans

MASSACHUSETTS (Medfield) - Dermatofibrosarcoma protubcrans

DIAGNOSlS:

DERMATOFIBROSARCOMA PROTUBERANS, LEFT THIGH AND GROIN

TY9100, M88321

REFERENCES:

Pedentour F, Coindre JM, Sozzi G, et at. Supernumerary Ring Chromosomes Containing Chromosome 17 Sequences. A Specific Feature of Dermatofibrosarcoma Protuberans. Cancer Gefltl Cytogenetl994; 76(1):1-9.

JimenezFJ, Grichnick JM, Buchanan MD and ClarkRE. Immunohistochemical Margin Control Applied to Mohs Micrographic Surgical Excision ofOcnnatofibrosarcomo Proruberans. J. Dermato S11rg Oncol 1994; 20 (10):687·689. (Used CD-34 Antigen to Clearly Mark Extent of Tumor).

Connelly JH and Evans HL. Dermatofibrosarcoma Protuberans. A Clinicopathologic Review with Emphasis on Fibrosarcomatous Areas. Am J S11rg Patho/1992; 16:921-925.

Lopes JM and Paviva ME. Dermatofibrosarcoma Proruberans. Histological and UltraStructural Srudy of II Cases with Emphasis on the Srudy of Recurrences and Histogenesis. Pathol Res Prac/ 1991; 187:806-813.

Diaz-Cascajo C, Weyers W, Borrego L, ct a!. Oennatofibrosarcoma Proruberans with Fibrosarcomatous Areas. A Clinicopathologic and Immunohistochemical Study of Four Cases. Am J Durmatopatho/ 1991; 19(6):562·567. (Director's note: All flbrosarcomatous OFSPs in this study were CD·34 positive.)

CASE NO. 3 ACCESSION NO. 28390 SEPTEMBER 1998

CALIFORNIA (Glendale) - Myxofibrosarcoma

ARIZONA (Phoenix) - Myxoid malignant fibrous histiocytoma

UTAH (Salt Lake City) - Pleomorphic liposarcoma

OKLAHOMA (Ardmore) - Sarcoma, favor liposarcoma (myxoid typer

MICHIGAN (Royal Oak) - Myxoid and round cell liposarcoma

MICHIGAN (Arm Ar·bor) - Myxoid malignant fibrous histiocytoma

INDIANA (Fort Wayne) - Dedifferentiated retroperitoneal liposarcoma (with MFH pattern); high grade myxoid MFR

KENTUCKY (Ft. Knox) - Malignant fibrous-histiocytoma, myxoid variant

ILLINOIS (Par·k Ridge) - Vascular leiomyosarcoma

FLORIDA (Miami) - Pleomorphic liposarcoma {round cell)

FLORIDA {Winter Haven) - Liposarcoma

LOUISIANNA (]V!etairic) - Inflammatory malignant fibrous histiocytoma

NEW JERSEY (Short Hills) - Malignant fibrous histiocytoma

PENNSYL VANTA (Philadelphia) - Myxoid malignant fibrous histiocytoma

MASSACH\JSETfS <Medfield) - Myxoid malignant fibrohistiocytoma

DIAGNOSIS:

MYXOID MALlGNANT FffiROUS HISTIOCYTOMA, RETROPERITONEUM

REFERENCES:

TY4600, M88303

Jaques DP, Co it DG, Hajdu Sl, and Brennan MF. Management of Primary and Recurrent Soft Tissue Sarcoma of the Rctroperitoneum. Ann Surg 1990; 212:5 1-59.

BevHacqua RG, Rogattro A, Hajdu SI and Brennan MF. Prognostic Factors in Primary Retroperitoneal Soft Tissue· Sarcoma Arch Surg 1992; 126:328-334.

McGrath PC. Retroperitoneal Sarcomas. Sem Surg Onco/ 1994; I 0:364,368. Enterline HT. Histopathology of Sarcomas. Semin Oncol 198 1; 8: 133· I 55. Karakousis CP, Velez AF, Gerstenblulh BA and Driscoll BA. Resectability and Survival of Retroperitoneal

Sarcomas. Ann Surg Onco/ 1996; 3(2): 150-158. Liao QL, Parkekb SG, Rosenberg AE, and Mankin HJ. Assessing Prognosis lor High Grade Soft Tissue

Sarcomas. Search tor a Marker. Ann Surg Onco/1996; 3(6):550-557.


CALIFORNIA (Glendale) - Spindle cell lipoma

ARIZONA (Phoenix) - Spindle cell lipoma

UTAH (Salt Lake City) - Spindle cell lipoma

OKLAHOMA (Ardmore) - Benign lipoma, favor spindle type

MICHJGAN CRoval Oak) - Diffuse neurofibroma

MICHIGAN (Ann Arbor) - Spindle cell lipoma

INDIANA (Fort Wayne) - Spindle cell lipoma

KENTUCKY CFt. Knox) - Myxoid fibrolipoma vs pleomorphic lipoma

ILLINOIS (Park Ridge) - Spindle cell lipoma

FLORIDA CMiamil - Spindle cell lipoma FLORIDA (Winter Haven) - Spindle cell lipoma

LOUISIANNA (Metairie) • Spindle cell lipoma

SEPTEMBER 1998

NEW JERSEY (Short Hills) - lntennuscular hemangiomalangiomyolipoma, infiltrative

PENNSYLV ANlA (philadelphia) - Angiolipoma

MASSACHUSETTS CMedfieldl - Pleomorphic lipoma (spindle cell type)

DIAGNOSIS:

SPINDLE CELL LIPOMA, NECK TY0600,M88570

REFERENCES:

Shmookler BM and Enzingcr FM. Pleomorphic Lipoma. A Benign Tumor Simulating Liposarcoma. A Clinicopathologic Analysis of 48 Cases. Cancer 1981; 47: 126·133.

Richmond I, et al. Spindle Cell Lipoma- A Pseudoangiomatous Varianl Histopathol 199$; 27(2):201 . Goldsmith AJ, et al. Pathologic Qui~ Case I. Spindle Cell Lipoma. Arch Otolaryngol Head Neck Surg

1993; 119(5):570-572. Fechner RE. Spindle Cell Lipoma. Arch Otolaryngo/1984; 110(11):766-769.


CALIFORNIA (Glendale) • Pleomorphic liposarcoma

ARIZONA <Phoenix) - Liposarcoma, favor intermediate grade

UTAH (Salt Lake City) - Dedifferentiated liposarcoma

OKLAHOMA (Ardmore) - Pleomorphic liposarcoma

MICHIGAN (Royal Oak) - Pleomorphic liposarcoma

SEPTEMBER 1998

MICHIGAN CAnn Arbor) - Pleomorphic hyalinizing angioectatic tumor (soft parts)

INDIANA (Fort Wayne) • Angiolipoma with degenerative myofibroblastic changes

KENTUCKY (Ft. Knox) • Pleomorphic rhabdomyosarcoma

f!:UNOIS CPark Ridge) - Neurofibroma

FLORIDA (Miami) - Pleomorphic liposarcoma

FLORIDA (Winter Haven) - Liposarcoma

LOUJSIANNA (Metairie) - Sclerosing liposarcoma NEW JERSEY (Short Hills) - Atypical fibroxanthoma; Malignant fibrous histiocytoma

PENNSYLVANIA CPbiladelphia) • Pleomorphic lipoma (benign)

MASSACHUSEITS (Medfield) - Pleomorphic liposarcoma

DIAGNOSIS:

1\UXED LIPOSARCOMA, WELL DlFFERENTIATED AND PLEOMORPffiC SUBTYPES ("DEDJFFERENTIA TED LIPOSARCOMA"), THIGH

TY9JOO, M88513

REFERENCES:

Fletcher DC, Ackcnnan M, de Weaver L, et al. Correlation Between Clinicopathological Features and Karyotype in Lipomatous Tumors. A Report of 178 Cases from Chromosomes and Morphology (CHAMP) Collaborative Group. Am J Pathol 1996; 148(2):623-630.

Kilpatrick SE, Doyon J, Peter FM, et al. The Clinicopathologic Spectrum of Myxoid and Round Cell Liposarcoma. A Srudy of95 Cases. Cancer 1994; 77(8): 1450-1-!158.


CALIFORNJA (Glendale) - Neurofibroma

ARIZONA <Phoenix ) - Neurofibroma, atypical

UTAH (Salt Lake Citv) - Neurofibroma

OKLAHOMA (Ardmore) - "Borderline" neurofibromatous lesions of von Recklinghausen's disease

MIGHIGAN (Royal Oak) - Ancient neurofibroma

MICHIGAN (Ann Arbor) - Malignant peripheral nerve sheath tumor

INDIANA (fort Wayne) - Neurofibroma, thigh

KENTUCKY (Ft. Knox) - Malignant peripheral nerve sheath tumor with rhabc!omyoblastic differentiation (malignant Triton tumor)

ILLINOIS (park Ridge) - Malignant neurofibroma

FLORIDA CMjamil - Malignant Schwannoma

FLORIDA (Winter Haven) • Liposarcoma

LOUISIANNA (Metairie) - Neurofibroma

NEW JERSEY (Short Hills) - Neurofibroma with early malignant change

PENNSYLVANIA (Philadelphja) - Granular cell tumor or neurofibroma

MASSACHVSETfS (Medfield) - Neurofibrosarcoma

DIAGNOSIS:

MALIGNAl"T PERIPHERAL NERVE SHEATH TUMOR (MPNST), THIGH

TY9100, M95600

REFERENCES:

Kawahara E, Oda Y, Ooi A, Katsuda S, et al. Expression of Glial Fibrillary Acidic Protein (GFAP), Vimentin, S·l 00 Protein. Neurofilaments in 38 Schwannomas and 18 Neurofibromas. Am J Surg Par hoi 1988; 12(2): 115-120.

Saogueza OP and Reguena L. Neoplasms with Neural Differentiation. A Review Part II : Malignant Neoplasms. Am J Dermaropathol l998; 20( I ):89-1 02.


CALfFORNIA CG icndale) • Sarcomatoid renal cell carcinoma

ARIZONA CPhoenjx) - Sarcoma, ? leiomyosarcoma

UTAH {Salt Lake Cjtyl - Leiomyosarcoma

OKLAHOMA CAr!lmorc) - leiomyosarcoma

SEPTEMBER 1998

MICHIGAN (Royal Oak) - Malignant spindled cell tumor probable malignant fibrous histiocytoma

MICHIGAN (Ann Arbor) - Epithelioid angiomyolipoma

INDIANA (Ft. Wayne) - Leiomyosarcoma, inferior pole, kidney

KENTUCKY {Ft. Knox) - Malignant muscular neoplasm - favor rhabdomyosarcoma (need to identify rhabdomyoblasts) rule out leiomyosarcoma

JLLfNOIS Q>ark Ridne) - Angiomyolipoma

FLORTDA {Miami) - Vascular Jeiomyosurcoma

ELORTDA CWjO)er Haven) - Sarcoma

LOUJSIANNA (Metairie) - Leiomyosarcoma

NEW JERSEY (Short Hills) - Leiomyosarcoma

PENNSYLVANIA (Philadelphia) - HcmangiopericytOma

MASSACHUSElTS (Medfield) - Hemangiopericytoma

DIAGNOSIS:

LEIOMYOSARCOMA, RENAL CAPSULE

REFERENCES:

T7 1150, M88903

Ochiai K., Onitsuka H, Honda H, et al. Leiomyosarcoma of lhe Kidney CT and MR. Appearance. J Comput Assist Tumor I 993; 17:656-658.

Grigon OJ, Ayala AG, Ro JY, et al. Primary Sarcomas of the Kidney. 1\ Clinicopathologic and DNA Flow Cytometric Study of 17 Cases. Ca11cer 1990; 65:1611-1618.

Myerson D, Rosenfield AT and ltzchak Y. Renal Capsular Tumors. 111c Angiographic Features. J Urol 1979; 121{2):238-241.

Tsukamota T and Lieber MM. Sarcomas of the Kidney, Urinary Bladder, Prostate, Spennatic Cord, Paratestis, and Testis in Adults. In: Raaf JH. ed Soft Tissue Sarcomas and Treatment . St. Louis Mosby Yearbook; 1992.


CALIFORNIA (Glendale) - Leiomyosarcoma

ARlZQNA (Phoenix) - Leiomyosarcoma UTAH (Salt Lake Cjty) - Leiomyosarcoma

OKLAHOMA (Ardmore) - Leiomyosarcoma

MICHIGAN CRoyal Oak) - Rhabdomyosarcoma

MICI-llGAN (Ann Arbor) - Leiomyosarcoma INDIANA (Ft. Wayne) - Leiomyosarcoma, femur

SEPTEMBER 1998

KENTUCKY (ft. Knox) - Rhabdomyosarcoma, spindle cell subtype of embryonal

ILLINOIS CPark Ridge) - Alveolar rhabdomyosarcoma

FLORIDA (Miami) - Leiomyosarcoma FLORIDA (Winter Haven) - Leiomyosarcoma

LOUTSIANNA (Metairie) - Leiomyosarcoma

NEW JERSEY (Short Hills) - Leiomyosarcoma PENNSYL V ANlA (Philadelphia) - Leiomyosarcoma

MASSACHUSETTS (Medfield) - Leiomyosarcoma

DIAGNOSIS:

LEIOMYOSARCOMA, LEG TY9400, M88903

REFERENCES:

Guillou L, Coindre JM, Bonichon F, Sui NB, eta I. Comparative Study of the National Cancer Institute and French Federation of Cancer Centers. Sarcoma Group Grading Systems in a Population of 410 Adult Patients with Soft Tissue Sarcoma. J Cli11 Onco/1997; 15{1):350-362.

Lazova R. Moynes R, May D, and Scon G. LN-2 (CD-74). A Marker to Distinguish Atypical f' ibroxunthoma from Malignant Fibrous Histiocytoma. Cancer 1997; 79:2115·2 124.

Fong Y, Coit DG, Woodruff JM and Bronnan MF. Lymph Node Metastasis from Soft Tissue Sarcoma in Aduhs-Analysis of Data from a Prospective Database of 1772 Sarcoma Patients. Ann Surg 1993; 217(1):72-77.

Hashimoto H, Daimaru Y, Takeshitu S, Tsuneyoshi, et al. Prognostic Significance of Histologic Parnmeters of Soft Tissue Sarcomas. Cancer 1992; 70(12):2816-2822.


CALIFORNIA <Glendale) - Leiomyosarcoma

ARJZONA (Phoenix) - Sarcoma, favor rhabdomyosarcoma"

UTAH (Salt Lake Citv) - Leiomyosarcoma

OKLAHOMA (Ardmore) - Myxoid malignant fibrous histiocytoma

MICHIGAN (Roval Oak) - Kaposi's sarcoma

MICHIGAN (Ann Arbor) - Monophasic synovial sarcoma

INDIANA (Ft. Wayne) - Inflammation myofibroblastic tumor

KENTUCKY (ft. Knox) - Sarcoma ?leiomyosarcoma. (final deferred pending additional workup and history concerning prior mass)

ILLINOIS (Park Ridge) - Malignant peripheral nerve tumor

FLORIDA (Miami) - Angiosarcoma

FLORIDA CWiriter Haven) - Dermatofibrosarcoma

LOUISIANNA (Metairie) - Malignant spindle cell neoplasm

NEW JERSEY <Short Hills) - Fibrosarcoma

PENNSYLVANIA {Philadelphia) - Rhabdomyosarcoma

MASSACHUSETTS {Medfield) - Myxoid fibrosarcoma

DIAGNOSIS:

FIBROSARCOMA WITH FOCAL MYXOID CHANGE ("MYXOFIBROSARCOMA"), LEG

REFERENCES:

TY9400, M88103

Fletcher CDM and Behan k Myxofibrosarcoma (Myxoid Malignant Fibrous Hi~tocytoma)" Clinicopathologit: Analysis of45 Cases with Emphasis on the Low Grade Variant (Abstract/ Lab lltVest 1992; 667A.

Angervall L, Kindblom LG and Merck t " Myxofibrosarcoma" A Sntdy of30 Cases" Acta ?athol Microbiol Scand(A) 1977; 85;127- 140"

Merck C, Angervall L, Kindblom LG, et at Myxofibrosarcoma. A Malignant Soft Tissue Tumor of Fibroblastic-Histiocytic Origin" A Clinicopathologic and Prognostic Srudy of 110 Cases Using Multivariate Analysis" API\1/S, Suppl282 1983; 91:1-40.

Evans HL. Low Grade Fibromyxoid Sarcoma. A Report of 12 Cases. Am J Surg Patho/1993; 17;595-600.


CALIFORNIA (Glendale) - Angiolipoma

ARIZONA (Phoenix) - Lipoma· like liposarcoma

UTAH (Salt Lake Citv) - Lipoma

OKLAHOMA (Ardmore) - Benign lipoma

MICHJGAN CRoyal Oak) - Angiolipoma

MTCHJGAN (Ann Arbor) - Atypical lipoma

TNDIANA (Ft. Wavne) - Atypical lipoma

KENTUCKY (Ft. Knox) - ? atypical lipoma

ILLINOIS (Park Ridge) - Well-differentiated liposarcoma

FLORIDA CMjami) - Atypical lipoma

FLORJDA (Winter Haven) - Fibrous lipoma

LOUlSIANNA (Metairie) - Lipoma

NEW JERSEY (Short Hills) - Lipoblastoma

PENNSYLVANIA (Philadelphia) - Well-differentiated liposarcoma

MASSACHVSETIS <Medfield) - Myxoid lipoma

DiAGNOSIS:

ATYPICAL LIPOMA, BACK

REFERENCE§:

TY I I 00, M88500

Suster Sand Fisher C. Immunoreactivity for the Human Hematopoetic Progenitor Cell Antigen (CD-34) in Lipomatous Tumors. Am J Surg Patho/1997; 21:195-200.

Michal M and Zamecnik M. Synovial Metaplasia in Lipoma. Am J Dcrmatopatho/1998; 20(3):285·289. Azumi N, Curtis J, Kempson RL, et al. Atypical and Malignant Neoplasms Showing Lipomatous.

Differentiation. A Study of I ll Cases. AmJSurg Pathof 1987: 11 :161-183.

131/surrounding the distal femur was a 13.0 x 12.0 x 5.0 em tumor involving the anterior, medial and...

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