Sarcoma and Look-Alikes: The Important Role of Ultrastructural Evaluation

Abstract

Due to the variable light microscopic appearance of sarcomas, a large number of neoplasms may need to be considered in the differential diagnosis in some situations. In difficult cases, the surgical pathologist must approach the differential diagnosis using ancillary diagnostic techniques and should do so in an orderly fashion, recognizing that arriving at the correct diagnosis is without a doubt the most important goal. It is also imperative to take into account the expense and time that may be involved in arriving to the definitive diagnosis, which could influence how the workup is conducted. Therefore, the most reasonable route to address the differential diagnosis in order to make a final solid diagnostic assessment should be taken. Whether immunohistochemistry, electron microscopy, cytogenetics, and/or molecular diagnostics should be employed in a given case becomes the dilemma. In some instances a combination of the above-mentioned techniques is important not only to obtain an unequivocal diagnosis, but also to provide important additional information regarding prognosis and to facilitate the patient's management.

Conjugated Nanoparticles for Solid Tumor Theranostics: Unraveling the Interplay of Known and Unknown Factors

“…Biopsies, a gold standard diagnostic approach, are especially susceptible to producing false-positive as well as false-negative results. They might consider low-grade fibromyxoid sarcoma as benign when it is in fact a malignant form . In comparison, benign lesions such as fibrous histiocytoma, cellular benign fibrous histiocytoma, and many more are mistaken for malignant forms of tumors. , Radiation diagnostics such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) scans are involved in the diagnosis.…”

“…They might consider low-grade fibromyxoid sarcoma as benign when it is in fact a malignant form . In comparison, benign lesions such as fibrous histiocytoma, cellular benign fibrous histiocytoma, and many more are mistaken for malignant forms of tumors. , Radiation diagnostics such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) scans are involved in the diagnosis. MRI is widely used but is not preferred for detecting retroperitoneal sarcoma .…”

Soft Tissue Sarcomas-The Pitfalls in Diagnosis and Management!!

“…[6][7][8] Benign Lesions that may be Confused as Malignant (Potential Pitfalls!) [8][9][10][11][12] The classical examples are a. Cellular benign fibrous histiocytoma that shows central necrosis in as many as 10-15% of cases and also very often extends into underlying subcutaneous adipose tissue.…”

“…c. Lipoma showing extensive microscopic areas of fat necrosis is very frequently mistaken for atypical lipomatous tumour-however, such lesions entirely lack true adipocytic or stromal nuclear atypia or hyperchromasia. A dedicated pathologist and immunohistochemical staining may help in making the diagnosis in these scenarios Malignant Lesions Mistaken as Benign [10][11][12][13] Low-grade fibromyxoid sarcoma is a prominent and the best-known example of this potential pitfall, although they have a characteristic translocation which can be detected by FISH or RT-PCR Histopathological Interpretation [High vs. low vs.…”