Fibrous Tumors and Tumor-Like Lesions

REACTIVE PSEUDOSARCOMATOUS PROLIFERATIONS

Reactive pseudosarcomatous proliferations are nonneoplastic lesions that either develop in response to some form of local trauma (physical or ischemic) or are idiopathic. They are

composed of plump reactive fibroblasts or related mesenchymal cells. Clinically, they are alarming because they develop suddenly and grow rapidly; histologically, they cause concern

because they mimic sarcomas owing to their hypercellularity,

Figure 26-53Myxoid liposarcoma with abundant ground substance in which are scattered adult-appearing fat cells and more primitive cells, some containing small lipid vacuoles

(lipoblasts).

Figure 26-54Nodular fasciitis with plump, randomly oriented spindle cells surrounded by myxoid stroma. Note the mitotic activity and extravasated red blood cells.

Figure 26-55Peripherally mineralized myositis ossificans (arrows) involving the posterior thigh.

Figure 26-56Fibromatosis infiltrating between skeletal muscle cells.

Figure 26-57Fibrosarcoma composed of malignant spindle cells arranged in a herringbone pattern.

Figure 26-58Malignant fibrous histiocytoma revealing fascicles of plump spindle cells in a swirling (storiform) pattern, typical but not pathognomonic of this neoplasm. (Courtesy of

Dr. J. Corson, Brigham and Women's Hospital, Boston, MA.)

Figure 26-59Rhabdomyosarcoma composed of malignant small round cells. The rhabdomyoblasts are large and round and have abundant eosinophilic cytoplasm; no cross-striations are

evident.

Figure 26-60Alveolar rhabdomyosarcoma with numerous spaces lined by tumor cells.

Figure 26-61Synovial sarcoma revealing the classic biphasic spindle cell and glandular-like histologic appearance.

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