Rhabdomyosarcoma differential diagnosis: Difference between revisions

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__NOTOC__
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{{Rhabdomyosarcoma}}
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Rhabdomyosarcoma]]
{{CMG}};{{AE}} {{PSK}}
{{CMG}};{{AE}} {{S.M}}


==Overview==
==Overview==
Rhabdomyosarcoma must be differentiated from [[Ewing sarcoma]], [[Lymphadenopathy]], [[Neuroblastoma]], [[Liposarcoma]] [[Osteosarcoma]], Lymphoprofilerative disorders. Rhabdomyosarcoma of the orbit must be differentiated from other causes of orbital masses such as orbital pseudotumor, orbital tumors, orbital abscess, and vascular lesions.
Rhabdomyosarcoma must be differentiated from [[wilms tumor]], [[ewing sarcoma]], [[neuroblastoma]], [[pheochromocytoma]], [[liposarcoma]], [[osteosarcoma]], [[acute myelocytic leukemia]], [[acute lymphoblastic leukemia]], and [[Non-Hodgkin lymphoma|non-hodgkin]] [[lymphoma]]. They mostly differentiated by their [[signs]], [[symptoms]], and [[imaging]] findings. The [[Gold standard (test)|gold standard]] of [[diagnosis]] is usually [[tissue]] [[biopsy]].


==Differential Diagnosis==
==Differential Diagnosis==
*Rhabdomyosarcoma must be differentiated from following diseases:
*[[Rhabdomyosarcoma]] must be differentiated from following [[diseases]]:


{| class="wikitable"
{| class="wikitable"
Line 14: Line 14:
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diagnosis
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diagnosis
|-
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Palpable mass
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Palpable mass
Line 22: Line 22:
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Others
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Others
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histology
|-
|-
|Rhabdomyosarcoma<ref name="pmid24966711">{{cite journal| author=Egas-Bejar D, Huh WW| title=Rhabdomyosarcoma in adolescent and young adult patients: current perspectives. | journal=Adolesc Health Med Ther | year= 2014 | volume= 5 | issue=  | pages= 115-25 | pmid=24966711 | doi=10.2147/AHMT.S44582 | pmc=4069040 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24966711  }}</ref><ref name="pmid27955730">{{cite journal| author=Dasgupta R, Fuchs J, Rodeberg D| title=Rhabdomyosarcoma. | journal=Semin Pediatr Surg | year= 2016 | volume= 25 | issue= 5 | pages= 276-283 | pmid=27955730 | doi=10.1053/j.sempedsurg.2016.09.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27955730  }}</ref><ref name="pmid18442956">{{cite journal| author=Park K, van Rijn R, McHugh K| title=The role of radiology in paediatric soft tissue sarcomas. | journal=Cancer Imaging | year= 2008 | volume= 8 | issue=  | pages= 102-15 | pmid=18442956 | doi=10.1102/1470-7330.2008.0014 | pmc=2365455 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18442956  }}</ref><ref name="pmid26349418">{{cite journal| author=Shern JF, Yohe ME, Khan J| title=Pediatric Rhabdomyosarcoma. | journal=Crit Rev Oncog | year= 2015 | volume= 20 | issue= 3-4 | pages= 227-43 | pmid=26349418 | doi= | pmc=5486973 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26349418  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Rhabdomyosarcoma]]<ref name="pmid24966711">{{cite journal| author=Egas-Bejar D, Huh WW| title=Rhabdomyosarcoma in adolescent and young adult patients: current perspectives. | journal=Adolesc Health Med Ther | year= 2014 | volume= 5 | issue=  | pages= 115-25 | pmid=24966711 | doi=10.2147/AHMT.S44582 | pmc=4069040 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24966711  }}</ref><ref name="pmid27955730">{{cite journal| author=Dasgupta R, Fuchs J, Rodeberg D| title=Rhabdomyosarcoma. | journal=Semin Pediatr Surg | year= 2016 | volume= 25 | issue= 5 | pages= 276-283 | pmid=27955730 | doi=10.1053/j.sempedsurg.2016.09.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27955730  }}</ref><ref name="pmid18442956">{{cite journal| author=Park K, van Rijn R, McHugh K| title=The role of radiology in paediatric soft tissue sarcomas. | journal=Cancer Imaging | year= 2008 | volume= 8 | issue=  | pages= 102-15 | pmid=18442956 | doi=10.1102/1470-7330.2008.0014 | pmc=2365455 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18442956  }}</ref><ref name="pmid26349418">{{cite journal| author=Shern JF, Yohe ME, Khan J| title=Pediatric Rhabdomyosarcoma. | journal=Crit Rev Oncog | year= 2015 | volume= 20 | issue= 3-4 | pages= 227-43 | pmid=26349418 | doi= | pmc=5486973 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26349418  }}</ref>
|
| style="background:#F5F5F5;" align="left" |
* Most common soft tissue cancer among children and adolescents
* Most common [[soft tissue]] [[cancer]] among children and adolescents
* The third most common extracranial solid tumors  
* The third most common extracranial [[solid]] tumors  
* Two-third of all cases happen under 6 years old
* Two-third of all cases happen under 6 years old
| +
| style="background:#F5F5F5;" align="left" | +
| +
| style="background:#F5F5F5;" align="left" | +
|
| style="background:#F5F5F5;" align="left" |
* Skin changes
* [[Skin]] changes
* Respiratory difficulties
* [[Respiratory]] difficulties
* Vomitting
* Vomitting
* Hematuria
* [[Hematuria]]
| +/-
| style="background:#F5F5F5;" align="left" | +/-
|
| style="background:#F5F5F5;" align="left" |
* Fever
* [[Fever]]
* Erythmatous skin
* Erythmatous [[skin]]
 
* [[Proptosis]]
* Proptosis
* Ophtalmoplasia
* Ophtalmoplasia
* Dysconjugate gaze
* Dysconjugate gaze
|
| style="background:#F5F5F5;" align="left" |
* [[Loss of heterozygosity]] of 11p15.
* [[Loss of heterozygosity]] of 11p15.
[[Mutations]] in:
[[Mutations]] in:
* [[TP53]]
* [[TP53]]
* [[NRAS]]
* [[NRAS]]
* [[KRAS]]
* [[KRAS]]
Line 56: Line 54:
* CTNNB1
* CTNNB1
* FGFR4
* FGFR4
* [[Translocations]] in [[PAX3]] or [[PAX7]] genes with [[FOXO1]]
* [[Translocations]] in [[PAX3]] or [[PAX7]] [[genes]] with [[FOXO1]]
| colspan="2" |CT scan:
| style="background:#F5F5F5;" align="left" |[[CT scan]]:
* Soft tissue density
* [[Soft tissue]] [[density]]
* Enhancement with contrast
* Enhancement with [[contrast]]
* Bone destruction
* [[Bone]] destruction
Ultrasound:
[[Ultrasound]]:
* Well-defined and irregular mass
* Well-defined and irregular mass
* Low to medium echogenicity
* Low to medium [[echogenicity]]
MRI:
[[MRI]]:
* T1:
* [[T1]]:
** Low to intermediate intensity
** Low to intermediate intensity
** Hemorrhage areas are poresent in alveolar rhabdomyosarcoma
** [[Hemorrhage]] areas are present in [[alveolar]] [[rhabdomyosarcoma]]
* T2:
* [[MRI|T2]]:
** Hyperintense
** Hyperintense
** Prominent flow voids are present in extremity lesions of rhabdomyosarcoma
** Prominent flow voids are present in extremity [[lesions]] of [[rhabdomyosarcoma]]
* T1 C+ (Gd):
* T1 C+(Gd):
** Considerable enhancement
** Enhancement
{| class="wikitable"
{| class="wikitable"
|
|
|}
|}
|
| style="background:#F5F5F5;" align="left" |
* An appearance of round blue cell tumors  
* An [[appearance]] of round [[blue]] [[cell]] [[tumors]]
* Myogenesis pathway has various types of differentiation
* [[Myogenesis]] pathway has various types of [[differentiation]]
* Positive immunohistochemical results for:  
* [[Positive]] [[Immunohistochemistry|immunohistochemical]] results for:  
** myoglobin  
** [[myoglobin]]
** actin
** [[actin]]
** desmin
** [[desmin]]
** Myogenin
** [[Myogenin]]
|-
|-
|[[Wilms' tumor|Wilms tumor]]<ref name="pmid61529362">{{cite journal |vauthors=Hartman DS, Sanders RC |title=Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation |journal=J Ultrasound Med |volume=1 |issue=3 |pages=117–22 |date=April 1982 |pmid=6152936 |doi= |url=}}</ref><ref name="pmid30036602">{{cite journal |vauthors=De Campo JF |title=Ultrasound of Wilms' tumor |journal=Pediatr Radiol |volume=16 |issue=1 |pages=21–4 |date=1986 |pmid=3003660 |doi= |url=}}</ref><ref name="pmid4080660">{{cite journal |vauthors=Cahan LD |title=Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease |journal=Pediatr Neurosci |volume=12 |issue=1 |pages=58–62 |date=1985 |pmid=4080660 |doi= |url=}}</ref><ref name="pmid10985142">{{cite journal| author=Coppes MJ, Pritchard-Jones K| title=Principles of Wilms' tumor biology. | journal=Urol Clin North Am | year= 2000 | volume= 27 | issue= 3 | pages= 423-33, viii | pmid=10985142 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10985142  }}</ref><ref name="pmid22789581">{{cite journal| author=Davidoff AM| title=Wilms tumor. | journal=Adv Pediatr | year= 2012 | volume= 59 | issue= 1 | pages= 247-67 | pmid=22789581 | doi=10.1016/j.yapd.2012.04.001 | pmc=3589819 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22789581  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Wilms' tumor|Wilms tumor]]<ref name="pmid61529362">{{cite journal |vauthors=Hartman DS, Sanders RC |title=Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation |journal=J Ultrasound Med |volume=1 |issue=3 |pages=117–22 |date=April 1982 |pmid=6152936 |doi= |url=}}</ref><ref name="pmid30036602">{{cite journal |vauthors=De Campo JF |title=Ultrasound of Wilms' tumor |journal=Pediatr Radiol |volume=16 |issue=1 |pages=21–4 |date=1986 |pmid=3003660 |doi= |url=}}</ref><ref name="pmid4080660">{{cite journal |vauthors=Cahan LD |title=Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease |journal=Pediatr Neurosci |volume=12 |issue=1 |pages=58–62 |date=1985 |pmid=4080660 |doi= |url=}}</ref><ref name="pmid10985142">{{cite journal| author=Coppes MJ, Pritchard-Jones K| title=Principles of Wilms' tumor biology. | journal=Urol Clin North Am | year= 2000 | volume= 27 | issue= 3 | pages= 423-33, viii | pmid=10985142 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10985142  }}</ref><ref name="pmid22789581">{{cite journal| author=Davidoff AM| title=Wilms tumor. | journal=Adv Pediatr | year= 2012 | volume= 59 | issue= 1 | pages= 247-67 | pmid=22789581 | doi=10.1016/j.yapd.2012.04.001 | pmc=3589819 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22789581  }}</ref>
|
| style="background:#F5F5F5;" align="left" |
* Also called nephroblastoma
* Also called [[nephroblastoma]]
* The most common childhood abdominal malignancy
* The most common childhood [[abdominal]] [[malignancy]]
* Average age of 3.5 years old
* [[Average]] [[age]] of 3.5 years old
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
| +
| +
|
| style="background:#F5F5F5;" align="left" |
* Hematuria
* [[Hematuria]]
* Respiratory symptoms ( due to lung metastases)
* [[Respiratory]] [[symptoms]] ( due to [[lung]] [[metastases]])
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
| style="background:#F5F5F5;" align="left" |
* Fever
* [[Fever]]
* Hypertension/ hypotension
* [[Hypertension]]/ [[hypotension]]
|Present mutations of:
| style="background:#F5F5F5;" align="left" |Present [[mutations]] of:
* WT1
* [[WT1]]
* P53
* [[P53]]
* FWT1
* FWT1
* FWT2 11p15.5 loci
* FWT2 11p15.5 [[loci]]
| colspan="2" |Ultrasound:
| style="background:#F5F5F5;" align="left" |[[Ultrasound]]:
*The best initial diagnostic study.
*The best initial [[Diagnostic study of choice|diagnostic study]].
*Distinguish [[tumor]] mass from other causes of renal swelling like [[hydronephrosis]].
*Distinguish [[tumor]] [[mass]] from other causes of renal [[swelling]] like [[hydronephrosis]].
*[[Doppler ultrasonography]] can help to detect invasion of [[renal vein]] and [[Inferior vena cava|IVC]] by the tumor.
*[[Doppler ultrasonography]] can help to detect [[invasion]] of [[renal vein]] and [[Inferior vena cava|IVC]] by the [[tumor]].
CT scan:
[[CT scan]]:
* Heterogeneous soft-tissue density masses
* [[Heterogeneous]] [[soft-tissue]] [[density]] [[mass]]
* Areas of [[calcification]] and fat-density regions
* Areas of [[calcification]] and [[fat]] [[density]] regions
 
*[[Lymph node]] [[metastasis]]
*[[Lymph node]] metastasis
*Surrounding [[organs]] [[invasion]]
*Surrounding organs invasion  
*[[Thrombus]] in [[renal vein]] or [[inferior vena cava]]
*[[Thrombus]] in [[renal vein]] or [[inferior vena cava]]
|
| style="background:#F5F5F5;" align="left" |
*Arises from mesodermal precursors of the renal parenchyma  
*Arises from mesodermal [[precursors]] of the [[renal]] [[parenchyma]]
*Well-circumscribed/ macrolobulated lesion
*Well-circumscribed/ macrolobulated [[lesion]]
*Hemorrhage/ central necrosis may be present
*[[Hemorrhage]]/ [[central]] [[necrosis]] may be present
*It is comprised of 3 types of cells:
*It is comprised of 3 types of [[Cells (biology)|cells]]:
**[[Stromal]]
**[[Stromal]]
**[[Epithelium|Epithelial]]
**[[Epithelium|Epithelial]]
**[[Blastema|Blastemal]]
**[[Blastema|Blastemal]]
 
*The [[stroma]] may include:
*The stroma may include:
**[[Striated muscle|Striated]] [[muscle]] [[cartilage]]
**Striated [[muscle]] [[cartilage]]
**[[bone]]
**[[bone]]
**[[Adipose tissue|Fat tissue]]
**[[Adipose tissue|Fat tissue]]
**[[Fibrous connective tissue|Fibrous tissue.]]
**[[Fibrous connective tissue|Fibrous tissue.]]
|-
|-
|Ewing sarcoma<ref name="pmid12560386">{{cite journal| author=Burchill SA| title=Ewing's sarcoma: diagnostic, prognostic, and therapeutic implications of molecular abnormalities. | journal=J Clin Pathol | year= 2003 | volume= 56 | issue= 2 | pages= 96-102 | pmid=12560386 | doi= | pmc=1769883 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12560386  }}</ref><ref name="pmid8443760">{{cite journal| author=Maygarden SJ, Askin FB, Siegal GP, Gilula LA, Schoppe J, Foulkes M et al.| title=Ewing sarcoma of bone in infants and toddlers. A clinicopathologic report from the Intergroup Ewing's Study. | journal=Cancer | year= 1993 | volume= 71 | issue= 6 | pages= 2109-18 | pmid=8443760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8443760  }}</ref><ref name="pmid8988217">{{cite journal| author=Panicek DM, Gatsonis C, Rosenthal DI, Seeger LL, Huvos AG, Moore SG et al.| title=CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: Report of the Radiology Diagnostic Oncology Group. | journal=Radiology | year= 1997 | volume= 202 | issue= 1 | pages= 237-46 | pmid=8988217 | doi=10.1148/radiology.202.1.8988217 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8988217  }}</ref><ref name="pmid29977059">{{cite journal| author=Grünewald TGP, Cidre-Aranaz F, Surdez D, Tomazou EM, de Álava E, Kovar H et al.| title=Ewing sarcoma. | journal=Nat Rev Dis Primers | year= 2018 | volume= 4 | issue= 1 | pages= 5 | pmid=29977059 | doi=10.1038/s41572-018-0003-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29977059  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Ewing sarcoma]]<ref name="pmid12560386">{{cite journal| author=Burchill SA| title=Ewing's sarcoma: diagnostic, prognostic, and therapeutic implications of molecular abnormalities. | journal=J Clin Pathol | year= 2003 | volume= 56 | issue= 2 | pages= 96-102 | pmid=12560386 | doi= | pmc=1769883 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12560386  }}</ref><ref name="pmid8443760">{{cite journal| author=Maygarden SJ, Askin FB, Siegal GP, Gilula LA, Schoppe J, Foulkes M et al.| title=Ewing sarcoma of bone in infants and toddlers. A clinicopathologic report from the Intergroup Ewing's Study. | journal=Cancer | year= 1993 | volume= 71 | issue= 6 | pages= 2109-18 | pmid=8443760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8443760  }}</ref><ref name="pmid8988217">{{cite journal| author=Panicek DM, Gatsonis C, Rosenthal DI, Seeger LL, Huvos AG, Moore SG et al.| title=CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: Report of the Radiology Diagnostic Oncology Group. | journal=Radiology | year= 1997 | volume= 202 | issue= 1 | pages= 237-46 | pmid=8988217 | doi=10.1148/radiology.202.1.8988217 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8988217  }}</ref><ref name="pmid29977059">{{cite journal| author=Grünewald TGP, Cidre-Aranaz F, Surdez D, Tomazou EM, de Álava E, Kovar H et al.| title=Ewing sarcoma. | journal=Nat Rev Dis Primers | year= 2018 | volume= 4 | issue= 1 | pages= 5 | pmid=29977059 | doi=10.1038/s41572-018-0003-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29977059  }}</ref>
| style="background:#F5F5F5;" align="left" |
* Include [[ewing sarcoma]], askin [[tumor]], and peripheral  [[Neuroectodermal tumor primitive|neuroectodermal tumors primitive]]
* The second most common [[childhood]] [[malignant]] primary [[bone]] [[tumors]]
* Usually arises in the long [[bones]] of the [[extremities]]
* Common [[age]] between 10-20 years old
|<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="left" | +
|
|
* Include ewing sarcoma, askin tumor, and peripheral primitive neuroectodermal tumors
* [[Weight loss]]
* The second most common childhood malignant primary bone tumors
* [[Fatigue]]
* Usually arises in the long bones of the extremities
* Common age between 10-20 years old
|<nowiki>+</nowiki>
| +
|Weight loss/ fatigue
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
| style="background:#F5F5F5;" align="left" |
* Fever
* [[Fever]]
* Pathologic fractures
* [[Pathological|Pathologic]] [[fractures]]
* Petachia/ purpura
* [[Petechiae]]/ [[purpura]]
|
| style="background:#F5F5F5;" align="left" |
* Reciprocal translocation between chromosomes 11 and 22
* [[Reciprocal translocation]] between [[chromosomes]] 11 and 22
| colspan="2" |Plain radiographic of region:
| style="background:#F5F5F5;" align="left" |[[Radiographic]] of region:
* Poorly marginated destructive lesion  
* Poorly marginated destructive [[lesion]]
* Permeative or "moth-eaten" appearance
* Permeative or "moth-eaten" [[appearance]]
CT scan:
[[CT scan]]:
* Cortical destruction  
* [[Cortical area|Cortical]] destruction  
* Demonstrate soft tissue disease
* Demonstrate [[soft tissue]] [[disease]]
MRI:
[[MRI]]:
* Considered as a preferred diagnostic study
* Considered as a preferred [[Diagnostic study of choice|diagnostic study]]
* Better shows tumor size/ intraosseous/extraosseous extent
* Better shows [[tumor]] size/ [[intraosseous]]/extraosseous extent
|
| style="background:#F5F5F5;" align="left" |
* Small/ round/ blue cell tumors
* Small/ round/ [[blue]] cell [[tumors]]
* May be undifferentiated or differentiated,
* May be [[undifferentiated]] or differentiated
* Regular sized primitive appearing cells
* Regular sized [[Primitive (integral)|primitive]] appearing [[Cells (biology)|cells]]
|-
|-
|Pediatric neuroblastoma <ref name="pmid12110723">{{cite journal| author=Lonergan GJ, Schwab CM, Suarez ES, Carlson CL| title=Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. | journal=Radiographics | year= 2002 | volume= 22 | issue= 4 | pages= 911-34 | pmid=12110723 | doi=10.1148/radiographics.22.4.g02jl15911 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12110723  }}</ref><ref name="pmid12580370">{{cite journal| author=Golden CB, Feusner JH| title=Malignant abdominal masses in children: quick guide to evaluation and diagnosis. | journal=Pediatr Clin North Am | year= 2002 | volume= 49 | issue= 6 | pages= 1369-92, viii | pmid=12580370 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12580370  }}</ref><ref name="pmid2403727">{{cite journal| author=Angstman KB, Miser JS, Franz WB| title=Neuroblastoma. | journal=Am Fam Physician | year= 1990 | volume= 41 | issue= 1 | pages= 238-44 | pmid=2403727 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2403727  }}</ref><ref name="pmid6493702">{{cite journal| author=Musarella MA, Chan HS, DeBoer G, Gallie BL| title=Ocular involvement in neuroblastoma: prognostic implications. | journal=Ophthalmology | year= 1984 | volume= 91 | issue= 8 | pages= 936-40 | pmid=6493702 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6493702  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[neuroblastoma]] <ref name="pmid12110723">{{cite journal| author=Lonergan GJ, Schwab CM, Suarez ES, Carlson CL| title=Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. | journal=Radiographics | year= 2002 | volume= 22 | issue= 4 | pages= 911-34 | pmid=12110723 | doi=10.1148/radiographics.22.4.g02jl15911 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12110723  }}</ref><ref name="pmid12580370">{{cite journal| author=Golden CB, Feusner JH| title=Malignant abdominal masses in children: quick guide to evaluation and diagnosis. | journal=Pediatr Clin North Am | year= 2002 | volume= 49 | issue= 6 | pages= 1369-92, viii | pmid=12580370 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12580370  }}</ref><ref name="pmid2403727">{{cite journal| author=Angstman KB, Miser JS, Franz WB| title=Neuroblastoma. | journal=Am Fam Physician | year= 1990 | volume= 41 | issue= 1 | pages= 238-44 | pmid=2403727 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2403727  }}</ref><ref name="pmid6493702">{{cite journal| author=Musarella MA, Chan HS, DeBoer G, Gallie BL| title=Ocular involvement in neuroblastoma: prognostic implications. | journal=Ophthalmology | year= 1984 | volume= 91 | issue= 8 | pages= 936-40 | pmid=6493702 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6493702  }}</ref>
|
| style="background:#F5F5F5;" align="left" |
* Most common extracranial solid tumor of infancy
* Most common extracranial [[solid]] [[tumor]] of [[infancy]]
* Arising from  pluripotent sympathetic cells
* Arising from  [[pluripotent]] [[sympathetic]] [[Cells (biology)|cells]]
Age distribution:
[[Age]] distribution:
* < 1 years old ( 40%)  
* < 1 years old ( 40%)  
* 1-2 years old (35%)
* 1-2 years old (35%)
* > 2 years old (25%)
* > 2 years old (25%)
|
| style="background:#F5F5F5;" align="left" |
+ (Abdominal)
+ ([[Abdominal]])
| +
| style="background:#F5F5F5;" align="left" | +
|
| style="background:#F5F5F5;" align="left" |
* Constipation
* [[Constipation]]
* Weakness
* [[Weakness]]
* Diarrhea
* [[Diarrhea]]
|
| style="background:#F5F5F5;" align="left" |
+
+([[Abdominal]])
 
| style="background:#F5F5F5;" align="left" |
(Abdominal)
* [[Proptosis]]
|
* Periorbital [[ecchymosis]]
* Proptosis
* [[Horner syndrome]]
* Periorbital ecchymosis
* [[Opsoclonus myoclonus syndrome]]
* Horner syndrome
| style="background:#F5F5F5;" align="left" |
* Opsoclonus myoclonus syndrome
* [[Chromosome]] 1p [[Deletion (genetics)|deletion]]
|
* [[N-myc-interactor|N-myc]] [[amplification]]
* Chromosome1p deletion  
| style="background:#F5F5F5;" align="left" |[[CT scan]]:
* N-myc amplification
* [[Heterogeneous]] [[mass]]
| colspan="2" |CT scan:
* [[Calcification]]
* Heterogeneous mass
* [[Necrotic]] areas
* Calcifications
[[MRI]]:
* Necrotic areas
*[[T1]]:
MRI:
** [[heterogeneous]] [[mass]]
 
*[[Magnetic resonance imaging|T2]]:
T1:
** [[Heterogeneous]]/ hyperintense
* heterogeneous mass
** [[Cystic]]/ [[necrotic]] areas  
T2:
*C+ (Gd):
* heterogeneous/ hyperintense
** [[Heterogeneous]] [[mass]]
* cystic/necrotic areas  
| style="background:#F5F5F5;" align="left" |
C+ (Gd):
* Well defined/ infiltrative [[mass]]
* Heterogeneous mass
* Homer [[Wright stain|wright]] rosettes  
|
* [[Secretion]] of [[vanillylmandelic acid]] (VMA) and [[homovanillic acid]] (HVA)
* Well defined/ infiltrative mass
* Homer wright rosettes  
* Secretion of vanillylmandelic acid (VMA) and homovanillic acid (HVA)
|-
|-
|Pediatric pheochromocytoma<ref name="pmid23345359">{{cite journal| author=Leung K, Stamm M, Raja A, Low G| title=Pheochromocytoma: the range of appearances on ultrasound, CT, MRI, and functional imaging. | journal=AJR Am J Roentgenol | year= 2013 | volume= 200 | issue= 2 | pages= 370-8 | pmid=23345359 | doi=10.2214/AJR.12.9126 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23345359  }}</ref><ref name="pmid1988766">{{cite journal| author=Stein PP, Black HR| title=A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience. | journal=Medicine (Baltimore) | year= 1991 | volume= 70 | issue= 1 | pages= 46-66 | pmid=1988766 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1988766  }}</ref><ref name="pmid17876523">{{cite journal| author=Bravo EL| title=Pheochromocytoma: new concepts and future trends. | journal=Kidney Int | year= 1991 | volume= 40 | issue= 3 | pages= 544-56 | pmid=1787652 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1787652  }}</ref><ref name="pmid1787652">{{cite journal| author=Bravo EL| title=Pheochromocytoma: new concepts and future trends. | journal=Kidney Int | year= 1991 | volume= 40 | issue= 3 | pages= 544-56 | pmid=1787652 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1787652  }} </ref>
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[pheochromocytoma]]<ref name="pmid23345359">{{cite journal| author=Leung K, Stamm M, Raja A, Low G| title=Pheochromocytoma: the range of appearances on ultrasound, CT, MRI, and functional imaging. | journal=AJR Am J Roentgenol | year= 2013 | volume= 200 | issue= 2 | pages= 370-8 | pmid=23345359 | doi=10.2214/AJR.12.9126 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23345359  }}</ref><ref name="pmid1988766">{{cite journal| author=Stein PP, Black HR| title=A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience. | journal=Medicine (Baltimore) | year= 1991 | volume= 70 | issue= 1 | pages= 46-66 | pmid=1988766 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1988766  }}</ref><ref name="pmid17876523">{{cite journal| author=Bravo EL| title=Pheochromocytoma: new concepts and future trends. | journal=Kidney Int | year= 1991 | volume= 40 | issue= 3 | pages= 544-56 | pmid=1787652 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1787652  }}</ref><ref name="pmid1787652">{{cite journal| author=Bravo EL| title=Pheochromocytoma: new concepts and future trends. | journal=Kidney Int | year= 1991 | volume= 40 | issue= 3 | pages= 544-56 | pmid=1787652 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1787652  }} </ref>
|
| style="background:#F5F5F5;" align="left" |
* Rare catecholamine-secreting tumor
* [[Rare]] [[catecholamine]]-secreting [[tumor]]
* Occur in both children and adults
* Occur in both children and adults
* Average age of 11 years old
* [[Average]] [[age]] of 11 years old
* Associated with  neurofibromatosis, von Hippel-Lindau disease, tuberous sclerosis, Sturge-Weber syndrome, and multiple endocrine neoplasia (MEN) syndromes
* Associated with  [[neurofibromatosis]], [[von Hippel-Lindau disease]], [[tuberous sclerosis]], [[Sturge-Weber syndrome|sturge-weber syndrome]], and [[multiple endocrine neoplasia]] ([[Multiple endocrine neoplasia|MEN]]) [[syndromes]]
|<nowiki>-</nowiki>
| style="background:#F5F5F5;" align="left" |<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
| style="background:#F5F5F5;" align="left" |<nowiki>+/-</nowiki>
|
| style="background:#F5F5F5;" align="left" |
* Headache
* [[Headache]]
* sweating
* [[Sweating]]
* Weakness
* [[Weakness]]
* Convulsion
* [[Convulsion]]
|<nowiki>-</nowiki>
| style="background:#F5F5F5;" align="left" |<nowiki>-</nowiki>
|
| style="background:#F5F5F5;" align="left" |
* Hypertension  
* [[Hypertension]]
* Tachycardia
* [[Tachycardia]]
* Pallor face
* [[Pallor]] [[face]]
|Genetic mutation in:
|[[Genetic]] [[mutation]] in:
* NF1
* [[NF1]]
* RET
* [[RET gene|RET]]
* VHL
* [[VHL]]
* SDHD
* [[SDHD]]
* SDHC
* [[SDHC]]
* EGLN1
* [[EGLN1]]
* EGLN2
* [[EGLN2]]
* KIF1B
* [[KIF1B]]
* SDHAF2
* [[SDHAF2]]
* TMEM127
* [[TMEM127]]
* SDHA
* [[SDHA]]
* IDH1
* [[IDH1]]
* SDHB
* [[SDHB]]
* MAX
* [[MAX (gene)|MAX]]
* HIF2A
* HIF2A
* FH
* [[FH]]
| colspan="2" |Ultrasound:
| style="background:#F5F5F5;" align="left" |[[Ultrasound]]:
* Different appearance from solid to mixed cystic or solid to cystic
* Different [[appearance]] from [[solid]] to mixed [[cystic]] or [[solid]] to [[cystic]]
CT scan:
[[CT scan]]:
* Large and heterogenous
* Large and heterogenous
* Calcification
* [[Calcification]]
* Necrosis
* [[Necrosis]]
* Cystic changes
* [[Cystic]] changes
MRI (in extra adrenal tumors):
[[MRI]] (in extra [[adrenal]] [[tumors]]):
 
*[[T1]]:
T1:
** Heterogenous enhancement
* Heterogenous enhancement
** Hypointense
* Hypointense
*[[MRI|T2]]:
T2:
** Hyperintense
* Hyperintense
*T1 C+ (Gd):
T1 C+ (Gd):
** Heterogenous enhancement
* Heterogenous enhancement
| style="background:#F5F5F5;" align="left" |
|
* Zellballen pattern on [[microscopy]]
* Zellballen pattern on microscopy  
* Well-defined clusters
* Well-defined clusters
* Eosinophilic cytoplasm
* [[Eosinophilic]] [[cytoplasm]]
Positive stains for:
Positive stains for:
* Chromogranin for zellballlen cells  
* [[Chromogranin]] for zellballlen [[Cells (biology)|cells]]
* Neurospecific enolase markers for neuronal cells
* Neurospecific [[enolase]] markers for [[neuronal]] [[Cells (biology)|cells]]
* S-100 protein for sustentacular cells  
* [[S-100 protein|S-100]] [[protein]] for [[Sustentacular cell|sustentacular]] [[Cells (biology)|cells]]
|-
|-
|Pediatric osteosarcoma<ref name="pmid8000997">{{cite journal| author=Dorfman HD, Czerniak B| title=Bone cancers. | journal=Cancer | year= 1995 | volume= 75 | issue= 1 Suppl | pages= 203-10 | pmid=8000997 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8000997  }}</ref><ref name="pmid21071381">{{cite journal| author=Yarmish G, Klein MJ, Landa J, Lefkowitz RA, Hwang S| title=Imaging characteristics of primary osteosarcoma: nonconventional subtypes. | journal=Radiographics | year= 2010 | volume= 30 | issue= 6 | pages= 1653-72 | pmid=21071381 | doi=10.1148/rg.306105524 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21071381  }}</ref><ref name="pmid1884549">{{cite journal| author=Araki N, Uchida A, Kimura T, Yoshikawa H, Aoki Y, Ueda T et al.| title=Involvement of the retinoblastoma gene in primary osteosarcomas and other bone and soft-tissue tumors. | journal=Clin Orthop Relat Res | year= 1991 | volume=  | issue= 270 | pages= 271-7 | pmid=1884549 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1884549  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[osteosarcoma]]<ref name="pmid8000997">{{cite journal| author=Dorfman HD, Czerniak B| title=Bone cancers. | journal=Cancer | year= 1995 | volume= 75 | issue= 1 Suppl | pages= 203-10 | pmid=8000997 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8000997  }}</ref><ref name="pmid21071381">{{cite journal| author=Yarmish G, Klein MJ, Landa J, Lefkowitz RA, Hwang S| title=Imaging characteristics of primary osteosarcoma: nonconventional subtypes. | journal=Radiographics | year= 2010 | volume= 30 | issue= 6 | pages= 1653-72 | pmid=21071381 | doi=10.1148/rg.306105524 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21071381  }}</ref><ref name="pmid1884549">{{cite journal| author=Araki N, Uchida A, Kimura T, Yoshikawa H, Aoki Y, Ueda T et al.| title=Involvement of the retinoblastoma gene in primary osteosarcomas and other bone and soft-tissue tumors. | journal=Clin Orthop Relat Res | year= 1991 | volume=  | issue= 270 | pages= 271-7 | pmid=1884549 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1884549  }}</ref>
|
| style="background:#F5F5F5;" align="left" |
* The second most common primary bone tumor  
* The second most common primary [[bone]] [[tumor]]
* The third most common tumor among adolescents
* The third most common [[tumor]] among adolescents
* Can be primary or secondary
* Can be primary or secondary
* Primary osteosarcoma occurs in age of 10-20 years old
* Primary [[osteosarcoma]] occurs in [[age]] of 10-20 years old
* Secondary osteosarcoma occurs in older patients and is secondary to paget disease and bone infarcts
* Secondary [[osteosarcoma]] occurs in older [[patients]] and is secondary to [[paget disease]] and [[bone]] infarcts
* Accompanied with positive history of trauma
* Accompanied with positive history of [[trauma]]
| +
| style="background:#F5F5F5;" align="left" | +
| +
| style="background:#F5F5F5;" align="left" | +
|
| style="background:#F5F5F5;" align="left" |
* Soft tissue swelling
* [[Soft tissue]] [[swelling]]
* Fracture
* [[Fracture]]
* Night sweating
* [[Night Sweats|Night]] [[sweating]]
| +
| style="background:#F5F5F5;" align="left" | +
|
| style="background:#F5F5F5;" align="left" |
* Mass swelling
* [[Mass]] [[swelling]]
* Fever
* [[Fever]]
* Arthritis
* [[Arthritis]]
* Decreased joint range of motion
* Decreased [[joint]] [[range of motion]]
* Lymphadenopathy
* [[Lymphadenopathy]]
|
| style="background:#F5F5F5;" align="left" |
* Alteration in retinoblastoma gene (Rb)
* Alteration in [[retinoblastoma]] [[gene]] ([[Rb]])
| colspan="2" |Plain radiography:
| style="background:#F5F5F5;" align="left" |[[Radiography]]:
* Osteolytic/ osteoblastic feature
* [[Osteolytic metasteses|Osteolytic]]/ [[Osteoblastic osteosarcoma|osteoblastic]] feature
* Periosteum reaction
* [[Periosteum]] reaction
* Calcification or ossification
* [[Calcification]] or [[ossification]]
CT scan:
[[CT scan]]:
* Primary lesion and chest CT are required
* Primary [[lesion]] and [[chest]] [[CT]] are required
* Demonstrate tumor location and extension
* Demonstrate [[tumor]] location and [[extension]]
MRI:
[[MRI]]:
* Exact assessment of tumor extension  
* Exact assessment of [[tumor]] [[extension]]
* Involving joint to joint findings
* Involving [[joint]] to [[joint]] findings
|
| style="background:#F5F5F5;" align="left" |
* Contain various cellular pleomorphism and mitoses
* Contain various [[cellular]] [[pleomorphism]] and [[mitoses]]
* Poorly trabecular bone formation
* Poorly [[Trabecular bone|trabecular]] [[bone]] formation
* Fibrocystic and chondroblastic features
* [[Fibrocystic Disease|Fibrocystic]] and chondroblastic features
|-
|-
|Pediatric liposarcoma<ref name="pmid6861094">{{cite journal| author=Shmookler BM, Enzinger FM| title=Liposarcoma occurring in children. An analysis of 17 cases and review of the literature. | journal=Cancer | year= 1983 | volume= 52 | issue= 3 | pages= 567-74 | pmid=6861094 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6861094  }}</ref><ref name="pmid9386667">{{cite journal| author=Marcus KC, Grier HE, Shamberger RC, Gebhardt MC, Perez-Atayde A, Silver B et al.| title=Childhood soft tissue sarcoma: a 20-year experience. | journal=J Pediatr | year= 1997 | volume= 131 | issue= 4 | pages= 603-7 | pmid=9386667 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9386667  }}</ref><ref name="pmid16160117">{{cite journal| author=Murphey MD, Arcara LK, Fanburg-Smith J| title=From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. | journal=Radiographics | year= 2005 | volume= 25 | issue= 5 | pages= 1371-95 | pmid=16160117 | doi=10.1148/rg.255055106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16160117  }}</ref><ref name="pmid17372913">{{cite journal| author=Italiano A, Cardot N, Dupré F, Monticelli I, Keslair F, Piche M et al.| title=Gains and complex rearrangements of the 12q13-15 chromosomal region in ordinary lipomas: the "missing link" between lipomas and liposarcomas? | journal=Int J Cancer | year= 2007 | volume= 121 | issue= 2 | pages= 308-15 | pmid=17372913 | doi=10.1002/ijc.22685 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17372913  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[liposarcoma]]<ref name="pmid6861094">{{cite journal| author=Shmookler BM, Enzinger FM| title=Liposarcoma occurring in children. An analysis of 17 cases and review of the literature. | journal=Cancer | year= 1983 | volume= 52 | issue= 3 | pages= 567-74 | pmid=6861094 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6861094  }}</ref><ref name="pmid9386667">{{cite journal| author=Marcus KC, Grier HE, Shamberger RC, Gebhardt MC, Perez-Atayde A, Silver B et al.| title=Childhood soft tissue sarcoma: a 20-year experience. | journal=J Pediatr | year= 1997 | volume= 131 | issue= 4 | pages= 603-7 | pmid=9386667 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9386667  }}</ref><ref name="pmid16160117">{{cite journal| author=Murphey MD, Arcara LK, Fanburg-Smith J| title=From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. | journal=Radiographics | year= 2005 | volume= 25 | issue= 5 | pages= 1371-95 | pmid=16160117 | doi=10.1148/rg.255055106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16160117  }}</ref><ref name="pmid17372913">{{cite journal| author=Italiano A, Cardot N, Dupré F, Monticelli I, Keslair F, Piche M et al.| title=Gains and complex rearrangements of the 12q13-15 chromosomal region in ordinary lipomas: the "missing link" between lipomas and liposarcomas? | journal=Int J Cancer | year= 2007 | volume= 121 | issue= 2 | pages= 308-15 | pmid=17372913 | doi=10.1002/ijc.22685 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17372913  }}</ref>
|Considered as a nonrhabdomyosarcoma soft tissue sarcomas
One of the least frequent tumors during  childhood
 
Rarely seen in adolescents and age of < 8 years old
 
Average age is 50 years among adults
 
Occur mostly in lower extremities,  retroperitoneal region, and shoulder
| +
| +/-
|
* Weight loss
* Fatigue
| -
|
|
* Considered as a nonrhabdomyosarcoma [[soft tissue]] [[sarcomas]]
* One of the least frequent [[tumors]] during  [[childhood]]
* Rarely seen in adolescents and [[age]] of < 8 years old
* [[Average]] [[age]] is 50 years among adults
* Occur mostly in [[lower extremities]],  [[retroperitoneal]] region, and [[shoulder]]
| style="background:#F5F5F5;" align="left" | +
| style="background:#F5F5F5;" align="left" | +/-
| style="background:#F5F5F5;" align="left" |
* [[Weight loss]]
* [[Fatigue]]
| style="background:#F5F5F5;" align="left" | -
| style="background:#F5F5F5;" align="left" |
* N/A
* N/A
|
| style="background:#F5F5F5;" align="left" |
* Amplification of 12q13–15 region in  MDM2 and CDK4 genes
* [[Amplification]] of 12q13–15 region in  [[MDM2]] and [[CDK4]] [[genes]]
* Translocation of  t(12;16)(q13;p11.2) in myxoid liposarcoma
* [[Translocations|Translocation]] of  t (12;16) (q13;p11.2) in myxoid [[liposarcoma]]
| colspan="2" |CT scan:
| style="background:#F5F5F5;" align="left" |[[CT scan]]:
* Inhomogenous fatty structure
* Inhomogenous fatty structure
* Tumor mineralization
* [[Tumor]] [[mineralization]]
* Cortical bone erosion
* [[Cortical bone|Cortical]] [[bone]] erosion
* Calcification
* [[Calcification]]
* Infiltration to medistinum
* Infiltration to [[mediastinum]]
MRI:
[[MRI]]:
* Adipose content mass
* [[Adipose]] content [[mass]]
* Thin irregular [[septa]]
* Thin [[Irregular bone|irregular]] [[septa]]
* Hemorrhage
* [[Hemorrhage]]
* Necrosis areas
* [[Necrosis]] areas
|Divided into following subtypes:
| style="background:#F5F5F5;" align="left" |Divided into following subtypes:
* Well-differentiated
* Well-differentiated
* Dedifferentiated, Myxoid/roundcell
* Dedifferentiated, Myxoid/ round [[cell]]
* Pleomorphic
* [[Pleomorphic]]
Common findings:
Common findings:
* Lipoblasts presence
* Lipoblasts presence
* Cytoplasmic lipid vacuoles
* [[Cytoplasmic]] [[lipid]] [[vacuoles]]
* Chromatin spikes
* [[Chromatin]] spikes
|-
|-
|Pediatric acute myelocystic leukemia<ref name="pmid18064533">{{cite journal| author=Yamamoto JF, Goodman MT| title=Patterns of leukemia incidence in the United States by subtype and demographic characteristics, 1997-2002. | journal=Cancer Causes Control | year= 2008 | volume= 19 | issue= 4 | pages= 379-90 | pmid=18064533 | doi=10.1007/s10552-007-9097-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18064533  }}</ref><ref name="pmid23634996">{{cite journal| author=Cancer Genome Atlas Research Network. Ley TJ, Miller C, Ding L, Raphael BJ, Mungall AJ et al.| title=Genomic and epigenomic landscapes of adult de novo acute myeloid leukemia. | journal=N Engl J Med | year= 2013 | volume= 368 | issue= 22 | pages= 2059-74 | pmid=23634996 | doi=10.1056/NEJMoa1301689 | pmc=3767041 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23634996  }}</ref><ref name="pmid3864727">{{cite journal| author=Islam A, Catovsky D, Goldman JM, Galton DA| title=Bone marrow biopsy changes in acute myeloid leukaemia. I: Observations before chemotherapy. | journal=Histopathology | year= 1985 | volume= 9 | issue= 9 | pages= 939-57 | pmid=3864727 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3864727  }}</ref><ref name="pmid17587881">{{cite journal| author=Orazi A| title=Histopathology in the diagnosis and classification of acute myeloid leukemia, myelodysplastic syndromes, and myelodysplastic/myeloproliferative diseases. | journal=Pathobiology | year= 2007 | volume= 74 | issue= 2 | pages= 97-114 | pmid=17587881 | doi=10.1159/000101709 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17587881  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[acute myelocytic leukemia]]<ref name="pmid18064533">{{cite journal| author=Yamamoto JF, Goodman MT| title=Patterns of leukemia incidence in the United States by subtype and demographic characteristics, 1997-2002. | journal=Cancer Causes Control | year= 2008 | volume= 19 | issue= 4 | pages= 379-90 | pmid=18064533 | doi=10.1007/s10552-007-9097-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18064533  }}</ref><ref name="pmid23634996">{{cite journal| author=Cancer Genome Atlas Research Network. Ley TJ, Miller C, Ding L, Raphael BJ, Mungall AJ et al.| title=Genomic and epigenomic landscapes of adult de novo acute myeloid leukemia. | journal=N Engl J Med | year= 2013 | volume= 368 | issue= 22 | pages= 2059-74 | pmid=23634996 | doi=10.1056/NEJMoa1301689 | pmc=3767041 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23634996  }}</ref><ref name="pmid3864727">{{cite journal| author=Islam A, Catovsky D, Goldman JM, Galton DA| title=Bone marrow biopsy changes in acute myeloid leukaemia. I: Observations before chemotherapy. | journal=Histopathology | year= 1985 | volume= 9 | issue= 9 | pages= 939-57 | pmid=3864727 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3864727  }}</ref><ref name="pmid17587881">{{cite journal| author=Orazi A| title=Histopathology in the diagnosis and classification of acute myeloid leukemia, myelodysplastic syndromes, and myelodysplastic/myeloproliferative diseases. | journal=Pathobiology | year= 2007 | volume= 74 | issue= 2 | pages= 97-114 | pmid=17587881 | doi=10.1159/000101709 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17587881  }}</ref>
|
| style="background:#F5F5F5;" align="left" |
* Replacement of normal bone marrow cells with abnormal cells
* Replacement of [[normal]] [[Bone marrow cells|bone marrow]] [[Cells (biology)|cells]] with [[abnormal]] [[Cells (biology)|cells]]
* Myeloblast is malignant cell
* [[Myeloblasts|Myeloblast]] is [[malignant]] [[cell]]
* Wide distribution among childhood to adults
* Wide [[Distribution (pharmacology)|distribution]] among [[childhood]] to adults
* Survival rate of 60%
* [[Survival rate]] of 60%
* Common in down syndrome
* Common in [[down syndrome]]
|<nowiki>+/- ( Abdominal mass, mediastinal mass)</nowiki>
| style="background:#F5F5F5;" align="left" | +/- ( [[Abdominal]] [[mass]], [[mediastinal]] [[mass]])
|<nowiki>+ (bone pain, joint pain)</nowiki>
| style="background:#F5F5F5;" align="left" | + ([[bone]] [[pain]], [[joint]] [[pain]])
|
| style="background:#F5F5F5;" align="left" |
* Bleeding  
* [[Bleeding]]
* Infectious
* [[Infectious]]
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
| style="background:#F5F5F5;" align="left" |
* Lymphadenopathy
* [[Lymphadenopathy]]
* Hepatosplenomegaly
* [[Hepatosplenomegaly]]
* Bruising
* [[Bruising]]
* Petechiae
* [[Petechiae]]
* Pallor face
* [[Pallor]] [[face]]
* Anemia
* [[Anemia]]
* Fever
* [[Fever]]
 
| style="background:#F5F5F5;" align="left" |[[Genetic]] [[translocations]] include:
|Genetic translocations include:
*t (8;21)
*t(8;21)
*t (3;21)
*t(3;21)
*t (15;17)
*t(15;17)
| style="background:#F5F5F5;" align="left" |[[Radiography]]:
| colspan="2" |Radiography:
*[[Chest]] [[radiography]]:
 
** [[Diagnosis]] of [[mediastinal]] [[mass]]
Chest radiography:
*[[Extremities]] [[radiography]]:
* Diagnosis of mediastinal mass
** [[Metaphyseal]] [[bands]]  
Extremities radiography:
** [[Lytic]] [[lesions]]
* Metaphyseal bands   
** New [[Periosteal reaction|periosteal]] [[bone]] formation  
* Lytic lesions
** [[Pathological|Pathologic]] [[fractures]]
* New periosteal bone formation  
[[CT scan]]/ [[MRI]]:
* Pathologic fractures
* Thickening/ [[edema]] of the [[bowel]] wall in presence of [[abdominal]] [[pain]] or [[bowel]] [[infection]]
CT scan/ MRI:
* Detection of early [[sinusitis]]
* Thickening/ edema of the bowel wall in presence of abdominal pain or bowl infection
* [[Intracranial hemorrhage|Intracranial]] [[hemorrhage]] in presence of [[neurological]] [[symptoms]]
* Detection of early sinusitis
[[Radionuclide test|Radionuclide]] [[imaging]]:
* Intracranial hemorrhage in presence of neurological symptoms
* [[Detection theory|Detection]] of [[occult]] [[infection]]
Radionuclide imaging:
| style="background:#F5F5F5;" align="left" |
* Detection of occult infection
* [[Hyperplastic]] [[bone marrow]] with [[leukemia]] [[Cells (biology)|cells]] replacement
 
* [[Megaloblastic Anemias|Megaloblastic]] feature
|
* Decrease in [[normal]] [[hematopoietic cell]]
* Hyperplastic bone marrow with leukemia cells replacement
* Megaloblastic feature
* decrease in normal hematopoietic cell
|-
|-
|Pediatric acute lymphoblastic leukemia<ref name="pmid25184049">{{cite journal| author=Zuckerman T, Rowe JM| title=Pathogenesis and prognostication in acute lymphoblastic leukemia. | journal=F1000Prime Rep | year= 2014 | volume= 6 | issue=  | pages= 59 | pmid=25184049 | doi=10.12703/P6-59 | pmc=4108947 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25184049  }}</ref>
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[acute lymphoblastic leukemia]]<ref name="pmid25184049">{{cite journal| author=Zuckerman T, Rowe JM| title=Pathogenesis and prognostication in acute lymphoblastic leukemia. | journal=F1000Prime Rep | year= 2014 | volume= 6 | issue=  | pages= 59 | pmid=25184049 | doi=10.12703/P6-59 | pmc=4108947 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25184049 }}</ref><ref name="pmid18358930">{{cite journal| author=Pui CH, Robison LL, Look AT| title=Acute lymphoblastic leukaemia. | journal=Lancet | year= 2008 | volume= 371 | issue= 9617 | pages= 1030-43 | pmid=18358930 | doi=10.1016/S0140-6736(08)60457-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18358930 }}</ref>
|
| style="background:#F5F5F5;" align="left" |
* The most common malignancy among children
* The most common [[malignancy]] among children
* Few cases may associated with down syndrome, wiskott-aldrich syndrome, andataxia-telangiectasia
* Few cases may associated with [[down syndrome]], wiskott-   aldrich syndrome, and [[ataxia-telangiectasia]]
* Peak age of 2-5 years old
* Peak [[age]] of 2-5 years old
* Previous history of cancer/ drug exposure
* Previous history of [[cancer]]/ [[drug]] [[Exposure (photography)|exposure]]
* Bone marrow replaced with malognant lymphoblasts
* [[Bone marrow]] replaced with [[malignant]] [[lymphoblasts]]
|
| style="background:#F5F5F5;" align="left" |
 
+/-( Extramedullary [[mass]] in  [[abdomen]]/ [[head]]/ [[neck]])
+/-( Extramedullary masses in  abdomen/ head/neck)
| style="background:#F5F5F5;" align="left" | +/- ([[Musculoskeletal]] [[pain]])
| +/- (Musculoskeletal pain)
| style="background:#F5F5F5;" align="left" |
|
* [[Weakness]]
* Weakness
* [[Fatigue]]
* Fatigue
* [[Weight loss]]
* Weight loss
* [[Bleeding]]
* Bleesing
| style="background:#F5F5F5;" align="left" | -
| -
| style="background:#F5F5F5;" align="left" |
|
* [[Fever]]
* Fever
* [[Lymphadenopathy]]
* Lymphadenopathy
* [[Hepatosplenomegaly]]
* Hepatosplenomegaly
 
* [[Pallor]]
* [[Pallor]]
* [[Papilledema]]
* [[Papilledema]]
Line 417: Line 404:
* [[Cranial nerve palsy]]
* [[Cranial nerve palsy]]
* [[Dyspnea]]
* [[Dyspnea]]
|Chromosomal translocations:
| style="background:#F5F5F5;" align="left" |[[Chromosomal]] [[translocations]]:
* t(9;22)  
* t (9;22)  
* t(12;21)
* t (12;21)
* t(5;14)
* t (5;14)
* t(1;19)
* t (1;19)
| colspan="2" |Radiography:
| style="background:#F5F5F5;" align="left" |[[Radiography]]:
Chest x ray:
[[Chest]] [[x ray]]:
* Nodular masses
* [[Nodular]] [[mass]]
* Central lymphadenopathy
* [[Central]] [[lymphadenopathy]]
Bone x ray:
[[Bone]] [[x ray]]:
* Radiolucent metaphyseal bands
* Radiolucent [[metaphyseal]] [[bands]]
* Coarse trabeculation
* Coarse trabeculation
* Periosteal reactions
* [[Periosteal reaction]]
* Osteopenia
* [[Osteopenia]]
Brain MRI:
[[Brain]] [[MRI]]:
* Leukoencephalopathy
* [[Leukoencephalopathy]]
* Glial cell hyperplasia
* [[Glial cell]] [[hyperplasia]]
* Meningitis
* [[Meningitis]]
|Divided into 3 subgroups:
| style="background:#F5F5F5;" align="left" |Divided into 3 subgroups:
L1:
L1:
* Small lymphoblast cells
* Small [[lymphoblast]] [[Cells (biology)|cells]]
* Scant cytoplasm
* Scant [[cytoplasm]]
* Invisible nucleoli
* Invisible [[nucleoli]]
L2:
L2:
* Larger lymphoblast cells
* Larger [[lymphoblast]] [[Cells (biology)|cells]]
* Abundant cytoplasm
* Abundant [[cytoplasm]]
* Prominent nucleoli
* Prominent [[nucleoli]]
L3:
L3:
* Large lymphoblast cells
* Large [[lymphoblast]] [[Cells (biology)|cells]]
* Deep cytoplasmic basophilia
* Deep [[cytoplasmic]] [[basophilia]]
* Similar to Burkitt lymphoma  
* Similar to [[Burkitt lymphoma]]
|-
|-
|[[Burkitt's lymphoma|Burkitt lymphoma]]
! style="background:#DCDCDC;" align="center" |[[Pediatric]] [[Non-Hodgkin lymphoma|non-hodgkin]] [[lymphoma]]<ref name="pmid23297126">{{cite journal| author=Green MR, Gentles AJ, Nair RV, Irish JM, Kihira S, Liu CL et al.| title=Hierarchy in somatic mutations arising during genomic evolution and progression of follicular lymphoma. | journal=Blood | year= 2013 | volume= 121 | issue= 9 | pages= 1604-11 | pmid=23297126 | doi=10.1182/blood-2012-09-457283 | pmc=3587323 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23297126  }}</ref><ref name="pmid26174528">{{cite journal| author=Sandlund JT| title=Non-Hodgkin Lymphoma in Children. | journal=Curr Hematol Malig Rep | year= 2015 | volume= 10 | issue= 3 | pages= 237-43 | pmid=26174528 | doi=10.1007/s11899-015-0277-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26174528  }}</ref><ref name="pmid25655608">{{cite journal| author=El-Galaly TC, Hutchings M| title=Imaging of non-Hodgkin lymphomas: diagnosis and response-adapted strategies. | journal=Cancer Treat Res | year= 2015 | volume= 165 | issue= | pages= 125-46 | pmid=25655608 | doi=10.1007/978-3-319-13150-4_5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25655608  }}</ref>
|
| style="background:#F5F5F5;" align="left" |
|<nowiki>+/- (in non-endemic or sporadic form of the disease)</nowiki>
* [[Cancer]] derives from [[lymphocytes]]
|<nowiki>-</nowiki>
* Diverse [[age]] of incidence
|<nowiki>-</nowiki>
* Associated with [[autoimmune disorders]], previous [[cancer]] [[therapy]], and [[infection]]
|<nowiki>-</nowiki>
| style="background:#F5F5F5;" align="left" | +
|<nowiki>-</nowiki>
| style="background:#F5F5F5;" align="left" | -
|
| style="background:#F5F5F5;" align="left" |
|
* [[Lymph node]] [[swelling]]
* Abdominal [[ultrasonography]] may show [[splenomegaly]] and [[ascites]].
* [[Weight loss]]
|
* [[Anorexia]]
* Chest, abdomen, and pelvis [[CT]] scan may be helpful in the diagnosis of [[Burkitt's lymphoma]] but it is not done routinely.<ref name="medlineplus">Burkitt lymphoma. MedlinePlus. https://www.nlm.nih.gov/medlineplus/ency/article/001308.htm Accessed on September 30, 2015</ref>
* [[Abdominal]] [[pain]]
|
 
*On microscopic histopathological analysis, characteristic findings of Burkitt's lymphoma include:<ref name="pmid12610094">{{cite journal |author=Bellan C, Lazzi S, De Falco G, Nyongo A, Giordano A, Leoncini L |title=Burkitt's lymphoma: new insights into molecular pathogenesis |journal=J. Clin. Pathol. |volume=56 |issue=3 |pages=188–92 |year=2003 |month=March |pmid=12610094 |pmc=1769902 |doi= |url=http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=12610094}}</ref>
* [[Nausea]]/ [[vomiting]]
:*Medium-sized (~1.5-2x the size of a RBC) with uniform size ("monotonous") -- '''key feature''' (i.e. tumor nuclei size similar to that of [[histiocytes]] or [[endothelial cells]])
| style="background:#F5F5F5;" align="left" | + ([[Chest]] [[tenderness]])
:*Round nucleus
| style="background:#F5F5F5;" align="left" |
:*Small nucleoli
* [[Fever]]
:*Relatively abundant cytoplasm ([[basophilic]])
* [[Hepatosplenomegaly]]
:*Brisk mitotic rate and [[apoptotic]] activity
* [[Lymphadenopathy]]
:*Cellular outline usually appears squared off
* [[Seizure]]
:*"Starry-sky pattern":
* [[Petechiae]]
::*The ''stars'' in the pattern are tingible-body macrophages (macrophages containing [[apoptotic]] tumor cells.
| style="background:#F5F5F5;" align="left" |
::*The tumour cells are the ''sky''
* [[MLL2]]
* [[MEF2B]]
* [[EZH2]]
* [[EP300]]
* [[KMT2D]]
* [[CDKN2A]]
| style="background:#F5F5F5;" align="left" |[[Radiography]]:
*[[Chest]] [[x ray]]:
** [[Central]] [[lymphadenopathy]]
** [[Pleural effusion]]
** [[Pericardial effusion]]
[[CT scan]]:
* Presence of enlarged [[lymph node]] in [[chest]], [[abdomen]], and [[pelvis]]
[[Ultrasound]]:
* [[Hepatosplenomegaly]]
| style="background:#F5F5F5;" align="left" |[[Histology]] findings of [[Non-Hodgkin lymphoma|non-hodgkin]] [[lymphoma]] depend on:
* [[Cell]] [[differentiation]]
* [[Cell]] [[Lineage (evolution)|lineage]]
* Location of [[cell]] [[origin]]
|}
|}


Latest revision as of 13:26, 2 April 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

Rhabdomyosarcoma must be differentiated from wilms tumor, ewing sarcoma, neuroblastoma, pheochromocytoma, liposarcoma, osteosarcoma, acute myelocytic leukemia, acute lymphoblastic leukemia, and non-hodgkin lymphoma. They mostly differentiated by their signs, symptoms, and imaging findings. The gold standard of diagnosis is usually tissue biopsy.

Differential Diagnosis

Disease History/demography Symptoms Physical examination Diagnosis
Palpable mass Pain Others Mass tenderness Others Genetics Imaging Histology
Rhabdomyosarcoma[1][2][3][4]
  • Most common soft tissue cancer among children and adolescents
  • The third most common extracranial solid tumors
  • Two-third of all cases happen under 6 years old
 + + +/-

Mutations in:

CT scan:

Ultrasound:

MRI:

Wilms tumor[5][6][7][8][9] + + +/- Present mutations of: Ultrasound:

CT scan:

Ewing sarcoma[10][11][12][13] + + + Radiographic of region:

CT scan:

MRI:

Pediatric neuroblastoma [14][15][16][17]

Age distribution:

  • < 1 years old ( 40%)
  • 1-2 years old (35%)
  • > 2 years old (25%)

+ (Abdominal)

+

+(Abdominal)

CT scan:

MRI:

Pediatric pheochromocytoma[18][19][20][21] - +/- - Genetic mutation in: Ultrasound:

CT scan:

MRI (in extra adrenal tumors):

  • T1:
    • Heterogenous enhancement
    • Hypointense
  • T2:
    • Hyperintense
  • T1 C+ (Gd):
    • Heterogenous enhancement

Positive stains for:

Pediatric osteosarcoma[22][23][24] + + + Radiography:

CT scan:

MRI:

Pediatric liposarcoma[25][26][27][28] + +/- -
  • N/A
 CT scan:

MRI:

Divided into following subtypes:

Common findings:

Pediatric acute myelocytic leukemia[29][30][31][32] +/- ( Abdominal mass, mediastinal mass) + (bone pain, joint pain) +/- Genetic translocations include:
  • t (8;21)
  • t (3;21)
  • t (15;17)
 Radiography:

CT scan/ MRI:

Radionuclide imaging:

Pediatric acute lymphoblastic leukemia[33][34]

+/-( Extramedullary mass in abdomen/ head/ neck)

+/- (Musculoskeletal pain) - Chromosomal translocations:
  • t (9;22)
  • t (12;21)
  • t (5;14)
  • t (1;19)
 Radiography:

Chest x ray:

Bone x ray:

Brain MRI:

Divided into 3 subgroups:

L1:

L2:

L3:

Pediatric non-hodgkin lymphoma[35][36][37] + - + (Chest tenderness) Radiography:

CT scan:

Ultrasound:

Histology findings of non-hodgkin lymphoma depend on:

References

  1. ↑ Egas-Bejar D, Huh WW (2014). "Rhabdomyosarcoma in adolescent and young adult patients: current perspectives". Adolesc Health Med Ther. 5: 115–25. doi:10.2147/AHMT.S44582. PMC 4069040. PMID 24966711.
  2. ↑ Dasgupta R, Fuchs J, Rodeberg D (2016). "Rhabdomyosarcoma". Semin Pediatr Surg. 25 (5): 276–283. doi:10.1053/j.sempedsurg.2016.09.011. PMID 27955730.
  3. ↑ Park K, van Rijn R, McHugh K (2008). "The role of radiology in paediatric soft tissue sarcomas". Cancer Imaging. 8: 102–15. doi:10.1102/1470-7330.2008.0014. PMC 2365455. PMID 18442956.
  4. ↑ Shern JF, Yohe ME, Khan J (2015). "Pediatric Rhabdomyosarcoma". Crit Rev Oncog. 20 (3–4): 227–43. PMC 5486973. PMID 26349418.
  5. ↑ Hartman DS, Sanders RC (April 1982). "Wilms' tumor versus neuroblastoma: usefulness of ultrasound in differentiation". J Ultrasound Med. 1 (3): 117–22. PMID 6152936.
  6. ↑ De Campo JF (1986). "Ultrasound of Wilms' tumor". Pediatr Radiol. 16 (1): 21–4. PMID 3003660.
  7. ↑ Cahan LD (1985). "Failure of encephalo-duro-arterio-synangiosis procedure in moyamoya disease". Pediatr Neurosci. 12 (1): 58–62. PMID 4080660.
  8. ↑ Coppes MJ, Pritchard-Jones K (2000). "Principles of Wilms' tumor biology". Urol Clin North Am. 27 (3): 423–33, viii. PMID 10985142.
  9. ↑ Davidoff AM (2012). "Wilms tumor". Adv Pediatr. 59 (1): 247–67. doi:10.1016/j.yapd.2012.04.001. PMC 3589819. PMID 22789581.
  10. ↑ Burchill SA (2003). "Ewing's sarcoma: diagnostic, prognostic, and therapeutic implications of molecular abnormalities". J Clin Pathol. 56 (2): 96–102. PMC 1769883. PMID 12560386.
  11. ↑ Maygarden SJ, Askin FB, Siegal GP, Gilula LA, Schoppe J, Foulkes M; et al. (1993). "Ewing sarcoma of bone in infants and toddlers. A clinicopathologic report from the Intergroup Ewing's Study". Cancer. 71 (6): 2109–18. PMID 8443760.
  12. ↑ Panicek DM, Gatsonis C, Rosenthal DI, Seeger LL, Huvos AG, Moore SG; et al. (1997). "CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: Report of the Radiology Diagnostic Oncology Group". Radiology. 202 (1): 237–46. doi:10.1148/radiology.202.1.8988217. PMID 8988217.
  13. ↑ Grünewald TGP, Cidre-Aranaz F, Surdez D, Tomazou EM, de Álava E, Kovar H; et al. (2018). "Ewing sarcoma". Nat Rev Dis Primers. 4 (1): 5. doi:10.1038/s41572-018-0003-x. PMID 29977059.
  14. ↑ Lonergan GJ, Schwab CM, Suarez ES, Carlson CL (2002). "Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation". Radiographics. 22 (4): 911–34. doi:10.1148/radiographics.22.4.g02jl15911. PMID 12110723.
  15. ↑ Golden CB, Feusner JH (2002). "Malignant abdominal masses in children: quick guide to evaluation and diagnosis". Pediatr Clin North Am. 49 (6): 1369–92, viii. PMID 12580370.
  16. ↑ Angstman KB, Miser JS, Franz WB (1990). "Neuroblastoma". Am Fam Physician. 41 (1): 238–44. PMID 2403727.
  17. ↑ Musarella MA, Chan HS, DeBoer G, Gallie BL (1984). "Ocular involvement in neuroblastoma: prognostic implications". Ophthalmology. 91 (8): 936–40. PMID 6493702.
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