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Cutaneous soft tissue tumors: diagnostically disorienting epithelioid tumors that are not epithelial, and other perplexing mesenchymal lesions.
Modern Pathology ( IF 7.5 ) Pub Date : 2019-11-04 , DOI: 10.1038/s41379-019-0387-5
Cody S Carter 1 , Rajiv M Patel 2
Affiliation  

Cutaneous soft tissue tumors with epithelioid features present a diagnostic challenge given that many entities in this category are rare, and they show morphologic overlap with significantly more common cutaneous epithelial and melanocytic neoplasms. The challenge is compounded by overlapping expression of epithelial or melanocytic markers in some of these entities. A broad spectrum of primary cutaneous epithelioid soft tissue tumors exists, including benign and malignant counterparts of tumors with various differentiation including melanocytic, peripheral nerve sheath, angiomatous, fibrohistiocytic, and myoid or myoepithelial, in addition to translocation-associated tumors lacking a derivative tissue type. Given this spectrum, an initial targeted immunohistochemical panel for epithelioid dermal and subcutaneous neoplasms is recommended, covering a broad spectrum of differentiation. In diagnostically challenging cases, select molecular studies can be employed to make critical distinctions between entities sharing morphologic and immunohistochemical properties. Due to sometimes marked differences in prognosis and treatment, knowledge and familiarity with epithelioid soft tissue tumors is key for any surgical pathologist who evaluates skin and subcutaneous biopsies and excision specimens. This concise review provides brief descriptions, key diagnostic features, and important modern ancillary studies for the diagnosis of non-epithelial, non-melanocytic cutaneous tumors that can exhibit a prominent degree of epithelioid morphology.

中文翻译:

皮肤软组织肿瘤:非上皮的上皮样肿瘤和其他令人困惑的间充质病变在诊断上令人迷惑。

具有上皮样特征的皮肤软组织肿瘤对诊断提出了挑战,因为该类别中的许多实体都很罕见,并且它们与更常见的皮肤上皮和黑色素细胞肿瘤在形态学上有重叠。在这些实体中的一些实体中,上皮或黑素细胞标记物的重叠表达使挑战变得更加复杂。存在广泛的原发性皮肤上皮样软组织肿瘤,包括具有各种分化的肿瘤的良性和恶性对应物,包括黑色素细胞、周围神经鞘、血管瘤、纤维组织细胞和肌样或肌上皮,此外还有缺乏衍生组织类型的易位相关肿瘤. 鉴于此范围,建议使用针对上皮样真皮和皮下肿瘤的初始靶向免疫组织化学组合,涵盖广泛的差异化。在具有诊断挑战性的病例中,可以采用选择的分子研究来对共享形态学和免疫组织化学特性的实体进行关键区分。由于有时预后和治疗存在显着差异,因此了解和熟悉上皮样软组织肿瘤对于任何评估皮肤和皮下活检和切除标本的外科病理学家来说都是关键。这篇简明综述提供了简要描述、关键诊断特征和重要的现代辅助研究,用于诊断可表现出显着程度的上皮样形态的非上皮、非黑素细胞皮肤肿瘤。选择分子研究可用于对共享形态学和免疫组织化学特性的实体进行关键区分。由于有时预后和治疗存在显着差异,因此了解和熟悉上皮样软组织肿瘤对于任何评估皮肤和皮下活检和切除标本的外科病理学家来说都是关键。这篇简明综述提供了简要描述、关键诊断特征和重要的现代辅助研究,用于诊断可表现出显着程度的上皮样形态的非上皮、非黑素细胞皮肤肿瘤。选择分子研究可用于对共享形态学和免疫组织化学特性的实体进行关键区分。由于有时预后和治疗存在显着差异,因此了解和熟悉上皮样软组织肿瘤对于任何评估皮肤和皮下活检和切除标本的外科病理学家来说都是关键。这篇简明综述提供了简要描述、关键诊断特征和重要的现代辅助研究,用于诊断可表现出显着程度的上皮样形态的非上皮、非黑素细胞皮肤肿瘤。了解和熟悉上皮样软组织肿瘤是任何评估皮肤和皮下活检和切除标本的外科病理学家的关键。这篇简明综述提供了简要描述、关键诊断特征和重要的现代辅助研究,用于诊断可表现出显着程度的上皮样形态的非上皮、非黑素细胞皮肤肿瘤。了解和熟悉上皮样软组织肿瘤是任何评估皮肤和皮下活检和切除标本的外科病理学家的关键。这篇简明综述提供了简要描述、关键诊断特征和重要的现代辅助研究,用于诊断可表现出显着程度的上皮样形态的非上皮、非黑素细胞皮肤肿瘤。
更新日期:2019-11-04
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