Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma.
Bone Neoplasms/secondary ; Carcinoma, Renal Cell/pathology/radiography ; Diagnosis, Differential ; Fibrosarcoma/radiography ; Histiocytoma/radiography ; Humans ; Kidney Neoplasms/*pathology/radiography ; Leiomyosarcoma/pathology/radiography ; Magnetic Resonance Imaging ; Middle Aged ; Neuroectodermal Tumors, Primitive/pathology/radiography ; Osteosarcoma/pathology ; Sarcoma ; Sarcoma, Synovial/radiography ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the diagnostic criteria and morphologic difference of primary schwannoma from that of soft tissue schwannoma.

METHODSAll neurogenic tumors of the bone in this hospital from 2002 to 2013 were reviewed, four cases of primary schwannoma arising from bone were selected. Their clinical features, radiologic appearance and pathologic findings were evaluated. Immunophenotyping was performed using EnVision method.

RESULTSAll four cases had classic morphologic features and immunophenotype of conventional schwannoma. Compared with schwannoma of the soft tissue, primary bone schwannoma had the following features: benign radiological appearance, absence of capsule under light microscope, local infiltration of bone or destruction of bone cortex, occasionally involving extra-osseous soft tissue. Most tumors were solid, with less cystic degeneration. Histologically, the tumors were mainly composed of compact areas of spindle cells (Antoni A), and areas of hypercellularity could often be observed.

CONCLUSIONSPrimary schwannoma of the bone is rare, usually arises within the long bones and flat bones. Compared to conventional soft tissue schwannoma, it shows different growth pattern, imaging and pathologic features; thus care should be exercised not to misdiagnose schwannoma of the bone as other primary low-grade malignant spindle cell sarcoma of the bone and to avoid unnecessary over-treatment.

Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Immunophenotyping ; Neurilemmoma ; diagnosis ; diagnostic imaging ; pathology ; Radiography ; Sarcoma ; diagnosis ; diagnostic imaging ; pathology

Actins ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Hemangiosarcoma ; metabolism ; pathology ; Humans ; Leiomyosarcoma ; metabolism ; pathology ; Middle Aged ; Multimodal Imaging ; Pulmonary Artery ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; Soft Tissue Neoplasms ; secondary ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Vimentin ; metabolism

Alveolar soft part sarcoma (ASPS) is a rare malignant soft-tissue neoplasm of unknown histogenesis. The two main sites of occurrence are the lower extremities in adults and the head and neck in children. We report the first case of pleural ASPS occurring in a 58-yr-old man who presented with progressive dyspnea. A computed tomographic scan of the thorax revealed a large enhancing pleural mass with pleural effusion in the left hemithorax. Wide excision of the pleural mass was performed. Histologically, the tumor consisted of organoid nests of large polygonal cells, the cytoplasm of which had eosinophilic and D-PAS positive granules. Immunohistochemical staining showed that the tumor cell nuclei were positive for transcription factor 3 (TFE3). The pleural ASPS with multiple bone metastases recurred 1 yr after surgery and the patient died of acute pulmonary embolism 1.5 yr after diagnosis.
Bone Neoplasms/diagnosis/secondary ; Dyspnea/etiology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pleura/physiopathology ; Positron-Emission Tomography and Computed Tomography ; Pulmonary Embolism/diagnosis ; Sarcoma, Alveolar Soft Part/*diagnosis/pathology/radiography ; Soft Tissue Neoplasms/*diagnosis/pathology/radiography ; Transcription Factor 3/metabolism

No abstract available.
Antigens, CD/metabolism ; Cell Adhesion Molecules/metabolism ; Female ; Humans ; Immunohistochemistry ; Peritoneum/metabolism/pathology ; Sarcoma, Ewing/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed ; Young Adult

We report here a case of inguinal sparganosis, initially regarded as myeloid sarcoma, diagnosed in a patient undergone allogeneic hematopoietic transplantation (HSCT). A 56-year-old male patient having myelodysplastic syndrome was treated with allogeneic HSCT after myeloablative conditioning regimen. At day 5 post-HSCT, the patient complained of a painless palpable mass on the left scrotum and inguinal area. Pelvic magnetic resonance imaging and computed tomography revealed suspected myeloid sarcoma. Gun-biopsy was performed, and the result revealed eosinophilic infiltrations without malignancy. Subsequent serologic IgG antibody test was positive for sparganum. Excisional biopsy as a therapeutic diagnosis was done, and the diagnosis of sparganosis was confirmed eventually. This is the first report of sparganosis after allogeneic HSCT mimicking myeloid sarcoma, giving a lesson that the physicians have to consider the possibility of sparganosis in this clinical situation and perform adequate diagnostic and therapeutic approaches.
Animals ; Diagnosis, Differential ; Hematopoietic Stem Cell Transplantation ; Humans ; Larva ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelodysplastic Syndromes/complications/surgery ; Republic of Korea ; Sarcoma, Myeloid/diagnosis ; Scrotum/parasitology/*pathology ; Sparganosis/parasitology/*pathology/radiography ; Sparganum/*immunology/isolation & purification ; Tomography, X-Ray Computed ; Transplantation, Homologous

Arthritis, Juvenile ; diagnosis ; pathology ; Biomarkers, Tumor ; blood ; Biopsy ; Bone Neoplasms ; diagnosis ; pathology ; Child, Preschool ; Diagnostic Errors ; Female ; Hip Joint ; diagnostic imaging ; pathology ; Humans ; Ilium ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Radiography ; Sarcoma, Ewing ; diagnosis ; pathology

OBJECTIVETo study the radiologic and pathologic features of primary intermediate hemangioendothelioma of the bone.

METHODSFive cases of primary intermediate hemangioendothelioma of bone encountered in the past three years were enrolled into the study. The clinical, radiologic, pathologic and immunohistochemical features of the tumors were reviewed.

RESULTSThe patients included 3 children with Kaposiform hemangioendothelioma and 2 elderly with retiform hemangioendothelioma. Four of the cases affected long bones and the remaining case affected the clavicle. One case showed multifocal involvement of the humerus. Radiologically, the tumors showed borderline to low-grade bony destruction, with various degrees of cortical defect. Intralesional or perilesional bone formation was demonstrated in 4 cases and radial spicules were seen in 1 case. The histopathologic features of primary intermediate hemangioendothelioma of bone were similar to those of soft tissue, except for the presence of reactive bone formation. Immunohistochemically, the tumor cells were positive for CD31 (5/5), CD34 (5/5), vimentin (5/5) and smooth muscle actin (3/5) but negative for cytokeratin and epithelial membrane antigen.

CONCLUSIONSPrimary intermediate hemangioendothelioma of bone is a distinct entity and similar histologic classification applies as in its soft tissue counterparts. Comparison of the biologic behavior requires long-term follow-up studies.

Actins ; metabolism ; Antigens, CD34 ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Child ; Clavicle ; pathology ; Diagnosis, Differential ; Female ; Femur ; pathology ; Hemangioendothelioma ; diagnostic imaging ; metabolism ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Humerus ; pathology ; Immunohistochemistry ; Infant ; Kasabach-Merritt Syndrome ; diagnostic imaging ; metabolism ; pathology ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Radiography ; Sarcoma, Kaposi ; diagnostic imaging ; metabolism ; pathology ; Vimentin ; metabolism

Nodular fasciitis is a benign, reactive myofibroblastic tumor that is often mistaken for a sarcoma because of its histological appearance and rapid growth. Involvement of a finger is extremely rare. We report a case of nodular fasciitis of the thumb, accompanied by bone erosion. Magnetic resonance findings suggested the possibility of a malignancy, which could have led to misdiagnosis as a malignant soft tissue sarcoma. Instead, the lesion was treated by excisional biopsy, which confirmed nodular fasciitis. There has been no evidence of local recurrence at recent follow-up, 1 year after surgery. This case illustrates that, to avoid unnecessarily aggressive surgery, nodular fasciitis must be included in the differential diagnosis for any finger lesion that resembles a sarcoma, even if bone erosion is present.
Adult ; Biopsy ; Diagnosis, Differential ; Fasciitis/*diagnosis/surgery ; Female ; Finger Phalanges/pathology/*radiography ; Humans ; Magnetic Resonance Imaging ; Sarcoma/*diagnosis ; Soft Tissue Neoplasms/*diagnosis ; Thumb/*pathology/surgery

Nodular fasciitis is a benign, reactive myofibroblastic tumor that is often mistaken for a sarcoma because of its histological appearance and rapid growth. Involvement of a finger is extremely rare. We report a case of nodular fasciitis of the thumb, accompanied by bone erosion. Magnetic resonance findings suggested the possibility of a malignancy, which could have led to misdiagnosis as a malignant soft tissue sarcoma. Instead, the lesion was treated by excisional biopsy, which confirmed nodular fasciitis. There has been no evidence of local recurrence at recent follow-up, 1 year after surgery. This case illustrates that, to avoid unnecessarily aggressive surgery, nodular fasciitis must be included in the differential diagnosis for any finger lesion that resembles a sarcoma, even if bone erosion is present.
Adult ; Biopsy ; Diagnosis, Differential ; Fasciitis/*diagnosis/surgery ; Female ; Finger Phalanges/pathology/*radiography ; Humans ; Magnetic Resonance Imaging ; Sarcoma/*diagnosis ; Soft Tissue Neoplasms/*diagnosis ; Thumb/*pathology/surgery