SOFT TISSUE PATHOLOGY

dr. Rizki Hanriko, Sp.PA

Dr. dr. Muhartono, S.Ked, M.Kes, Sp.PA
Laboratorium Anatomi-Histo-PA
FK UNILA
2016
Sel Mesenkimal

2
Enzinger & Weiss’s Soft Tissue Tumors, 2008
Adipocyte Tumor
Development
of adipose cell
Sel Lemak
Histogenesis

11
Developing lipoblasts from a myxoid liposarcoma, with an early stage, with fine
vacuoles, an intermediate stage, and a late stage resembling mature white fat.
Enzinger & Weiss’s Soft Tissue Tumors, 2008
Pleomorphic lipoblast from a pleomorphic liposarcoma.
Enzinger & Weiss’s Soft Tissue Tumors, 2008
 Lipoma
⚫ mature adipocytes
⚫ most common soft tissue neoplasms in
adults.
⚫ Superficial lipomas arise in the subcutis; deep
lipomas arise within the deep soft tissue;
⚫ Superficial tumors are generally <5 cm in
maximum dimension, whereas deep tumors
are often >5 cm.
⚫ well circumscribed and have an oily light
yellow cut surface, except in children whose
tumors are pale white.
 Liposarcoma

Enzinger & Weiss’s Soft Tissue Tumors, 2008

Enzinger & Weiss’s
Soft Tissue Tumors, 2008
Enzinger & Weiss’s Soft Tissue Tumors,
2008
Enzinger & Weiss’s Soft Tissue Tumors, 2008
Enzinger & Weiss’s Soft Tissue Tumors, 2008
 Typical appearance of a myxoid
liposarcoma.

Myxoid liposarcoma with

arborizing vasculature and
lipoblasts at varying stages.

Enzinger & Weiss’s Soft Tissue Tumors, 2008

Enzinger & Weiss’s Soft Tissue
Tumors, 2008
Fibroblastic Tumor
Fibroblas

25
 Nodular Fasciitis

⚫ all age, predilection for young adults.

⚫ subcutaneous tissue of the head and neck,
trunk, or upper extremities.
⚫ circumscribed, minimally infiltrative
spindle cell proliferations have a fibrous to
myxoid cut surface, and most are ø<2 cm.
⚫ Local excision is generally curative. Less
than 5% cases may have local recurrence.
 Fibromatoses
⚫ Locally aggressive, they do not metastasize.
⚫ The superficial fibromatoses arise in the
superficial fascia and include such entities as
palmar fibromatosis (Dupuytren contracture) and
penile fibromatosis (Peyronie disease).
⚫ Superficial lesions are genetically distinct from
their deep-seated cousins and are generally more
innocuous (they can be associated with trisomy 3
and 8);
⚫ come to clinical attention earlier, because they
cause deformity of the involved structure.
 Fibromatoses
⚫ The deep fibromatoses include the so-called
desmoid tumors that arise in the abdominal wall
and muscles of the trunk and extremities, and
mesentery and pelvic walls.
⚫ Isolated lesions, or multiple, as a component of
Gardner syndrome. Mutations in the APC or
β-catenin genes are present in a majority of
these tumors.
⚫ Deep fibromatoses tend to grow in a locally
aggressive manner and often recur after
excision.
 Fibrosarcoma
⚫ Most occur in adults, typically in the deep
tissues of the thigh, knee, and
retroperitoneal area.
⚫ tend to grow slowly, and have usually
been present for several years at the time
of diagnosis.
⚫ >50% recur locally after excision and
>25% can metastasize hematogenously,
usually to the lungs.
Fibrohistiocytic Tumor
 DFSP
Infiltration of deep dermis
and subcutis by the lesion
in a honeycomb
pattern. The superficial
dermis is spared.

Andrew LF, Bone and soft tissue pathology, 2010

Andrew LF, Bone and soft tissue pathology, 2010
Andrew LF, Bone and soft tissue pathology, 2010
WHO Soft tissue & Bone, 2013
Skeletal Muscle Tumor
Rhabdomyoma
Rhabdomyoma
Andrew LF, Bone and soft tissue pathology, 2010
Andrew LF, Bone and soft tissue pathology, 2010
 Rhabdomyosarcoma
⚫ Embryonal Rhabdomyosarcoma
⚫ Alveolar Rhabdomyosarcoma
⚫ Pleomorphic Rhabdomyosarcoma

⚫ Prognosis E>A>P
Andrew LF, Bone and soft tissue pathology, 2010
Andrew LF, Bone and soft tissue pathology, 2010
Andrew LF, Bone and soft tissue pathology, 2010
Smooth Muscle Tumor
Andrew LF, Bone and soft tissue pathology, 2010
Andrew LF, Bone and soft tissue pathology, 2010
TERIMAKASIH