A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Very effective this type of short format videos and Put signs on the road, with quick gain of most important tips, if anyone needs more go to long format.
SOOOO helpful! My son was just diagnosed with LGFMS and this helped sort out all the terminology. Thank you so much! (also, I teach anatomy so the histology was awesome)
@@JMGardnerMD thank you for asking. He’s 6yrs old. Left medial gastrocnemius. 5.3cm at the largest. (Writing from my other account). It’s been removed and he’s doing well. Now just trying to learn all I can. I’ve read through the relevant research you’ve posted. I’d love to read more if you have any recommendations!
Yes! Precisely the reason they are so tricky. The low power pattern is the key. Did you see the full length LGFMS video too? ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-QDb68_G1HR4.html
Could someone explain the below final pathology report? My friend has done Radio therapy prior to surgery. Macroscopic description: Wide resection. An excision of soft tissue 95x75x48mm consisting of fibrofatty tissue and skeletal muscle. The specimen is sectioned from medial-lateral into 14 discrete slices. Located in slices 4-6 and partially slice 7 is a heterogenous circumscribed soft solid mass 36x27x17mm (superior-inferior, medial-lateral, superficial-deep). Microscopic description: Sections show skeletal muscle with overlying skin. Within the skeletal muscle there is a circumscribed tumor composed of hyalinised tissue, areas of loose fibroblastic tissue, oedema, haemorrhage and a patchy lymphocytic infiltrate, consistent with treatment effect. Scattered through the tumor nodule there are single epthelioid cells, some multinucleated, with hyperchromatic, pleomorphic nuclei and atypical mitotic figures. Occasional spindle cells with similar nuclear features are also present. these atypical cells are interpreted as residual tumor cells. No tumor necrosis is seen. The tumor cells are positive for vimentin. there is some patchy staining for sox10, but the tumor cells are negative for s100 and melanA. There is patchy weak to moderate positivity for erg(interpreted to be non-specific reactivity), but the tumor is negative for cd31 and cd34. there is weak reactivity for cd99, interpreted as non-specific reactivity. The tumor is negative for cytokeratins ae1/ae3, cam52, berep4, 24be12, ck5/6, p40,ema and negative for sma, demin, cd34, cd68, and mdm2. there is retained expression of h3k27me3. Overall the features of resected tumor would be consistent with UPS. Grading of the post-treatment tumor has not been performed due to the scant tumor cells present. Diagnosis: Residual tumor cells are present 5mm from the inferior and superior margins and 6mm from the deep margin. No lymphovascular space invasion or perineural invasion is seen.
I can’t provide official medical advice since your friend is not my patient and I’m not their doctor. But I’m happy to share my general thoughts about the wording of this report. It sounds like a previous biopsy has been done correct? And I assume that biopsy was diagnosed as undifferentiated pleomorphic sarcoma (UPS), correct? Then the tumor was treated with radiation therapy before this complete excision was done. The report is basically saying that there’s only a small amount of living tumor cells left after the radiation therapy, which is good as it means the radiation therapy killed a lot of the tumor. All of those special stains that they mention basically showed nothing specific meaning that the tumor would fit with a diagnosis of UPS rather than some other specific type of sarcoma. UPS is a diagnosis of exclusion (we have to rule out the other types of sarcoma and other types of cancer that can mimic it). I hope that helps you and your friend better understand the wording of this report. Most importantly, make sure your friend discusses all of this with their doctor especially any questions or concerns they might have. Their sarcoma doctor will likely be the best person to answer any questions they have because they will be the most familiar with their specific situation and medical needs. Best wishes for healing for your friend.
@@JMGardnerMD Thanks for your reply. Much appreciated. Your assumptions are both correct. It is mentioned that "No tumor *necrosis* is seen" and "Grading of the post-treatment tumor has not been performed due to the *scant* tumor cells present." Would you be able to explain the *necrosis* and *scant tumor* bit? He mentioned that the doctor didn't provide much details and is also hard to get in contact with them since he's now out of hospital. He's got an appointment with his doctor but is months away. He's just eager to understand more the result which you actually did provide. Many thanks.
2 ultrasounds and an mri were inconclusive, but My biopsy came back as myxofibrosarcoma. It's on my thigh. Is it related to benign granular cell tumors ? I had one of those removed already... just curious.
I’m so sorry to hear this. Myxofibrosarcoma can be difficult to recognize clinically in its early stages. It can look a lot like a cyst or other benign skin condition. To my knowledge, there is no known relationship at all between myxofibrosarcoma and granular cell tumor. They are completely different types of tumor. Please make sure to seek care from a center that has experience in treating sarcomas. I find that orthopedic oncologists (orthopedic surgeons specializing in bone and soft tissue tumors like sarcomas) are often the most experienced in dealing with myxofibrosarcoma (and other sarcomas on the extremities). Best wishes for health and healing!
Thank you SO MUCH for your response. I meet My orthopedic surgeon in a week. Bizarrely, this is actually my 4th cancer, coming on the heels of ovarian cancer recovery. I have also had a melanoma, thyroid cancer, and have sclerosing pneumocytoma.. also rare. The sarcoma feels like the benign lump I had removed from my rib that was the granular cell tumor. So I was curious. I'm actually very healthy and under 50, but definitely wondering why all these weird, diagnoses! Definitely Blessed to keep catching these things in early stages but getting frustrated. Thanks again for your time Dr.
