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Fibrosarcoma
Last reviewed: 23.04.2024
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[Pathomorphology of fibrosarcoma
Pathomorphology depends on the prevalence of a particular type of cells and the degree of their differentiation. A.V. Smoliannikov (1982) histologically distinguishes two varieties of fibrosarcoma: differentiated and low-differentiated.
Differential fibrosarcoma
Differential fibrosarcoma is characterized by the presence of a large number of collagen fibers and the predominance of spindle-shaped elements with the correct arrangement of cell-fibrous strands. However, even with this form, it is possible to detect varying degrees of cell anaplasia and polymorphism.
Low-differentiated fibrosarcoma
Low-differentiated fibrosarcoma, in contrast, is characterized by the predominance of cellular elements over the fibrous substance. The expressed polymorphism of the cells, hyperchromatosis of the nuclei and the presence of pathological mitoses are noted. Anaplastic cells have clumpy nuclei, as a result of the fusion of which multinucleate giant cells are formed. There are large areas, consisting of polygonal cells, reminiscent of epithelioid. In some cases this type of cells predominates, which gives grounds to some authors to isolate a special form of fibrosarcoma - epithelioid cell. The nuclei of epithelioid cells are mostly large, light, but can also be polymorphic. Electron microscopy reveals expanded endoplasmic reticulum cages, polyribosomes, microfilaments located in the perinuclear zone, as well as lysosomes and pinocytosis vesicles along the cytoplasmic membrane. Sometimes epithelioid and spindle-shaped cells form biphasic or pseudoglandular structures. Epithelioid cells often undergo necrosis, and in connection with this variant of fibrosarcoma there are extensive foci of tumor disintegration. The number of fibrous substances with a low-grade sarcoma varies widely. There may be foci of myxomatous transformation, sometimes extensive, as a result of which sometimes such a variant is isolated in a special form called "myxosarcoma".
Differentiate the fibrosarcoma primarily from the Darje Ferran dermatofibrosarcoma. However, the latter is located only in the dermis and is characterized by moiré structures. Malignant histiocytoma, in contrast to fibrosarcoma, in addition to polymorphic cells, contains a large number of giant cells.
Symptoms of fibrosarcoma
Deep in the skin or subcutaneous tissue appear different sizes of nodes, covered with normal or cyanotic red skin, often with ulceration. Tumor occurs in people of both sexes, at any age, including children and even newborns, most often on the limbs, but sometimes on the body. Gives lymphogenous and hematogenous metastases.