Rhabdomyosarcoma differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Rhabdomyosarcoma]] | |||
{{CMG}};{{AE}} {{S.M}} | {{CMG}};{{AE}} {{S.M}} | ||
==Overview== | ==Overview== | ||
Rhabdomyosarcoma must be differentiated from [[ | 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== | ||
| Line 25: | Line 25: | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histology | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histology | ||
|- | |- | ||
! | ! 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]] | ||
| Line 44: | Line 44: | ||
* 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: | ||
| Line 55: | Line 55: | ||
* FGFR4 | * FGFR4 | ||
* [[Translocations]] in [[PAX3]] or [[PAX7]] [[genes]] with [[FOXO1]] | * [[Translocations]] in [[PAX3]] or [[PAX7]] [[genes]] with [[FOXO1]] | ||
| | | style="background:#F5F5F5;" align="left" |[[CT scan]]: | ||
* [[Soft tissue]] [[density]] | * [[Soft tissue]] [[density]] | ||
* Enhancement with [[contrast]] | * Enhancement with [[contrast]] | ||
| Line 65: | Line 65: | ||
* [[T1]]: | * [[T1]]: | ||
** Low to intermediate intensity | ** Low to intermediate intensity | ||
** [[Hemorrhage]] areas are present in alveolar [[rhabdomyosarcoma]] | ** [[Hemorrhage]] areas are present in [[alveolar]] [[rhabdomyosarcoma]] | ||
* [[MRI|T2]]: | * [[MRI|T2]]: | ||
** Hyperintense | ** Hyperintense | ||
| Line 74: | Line 74: | ||
| | | | ||
|} | |} | ||
| | | 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]] | ||
| Line 83: | Line 83: | ||
** [[Myogenin]] | ** [[Myogenin]] | ||
|- | |- | ||
! | ! 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]] | ||
| Line 90: | Line 90: | ||
|<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]] | ||
| | | style="background:#F5F5F5;" align="left" |Present [[mutations]] of: | ||
* [[WT1]] | * [[WT1]] | ||
* [[P53]] | * [[P53]] | ||
* FWT1 | * FWT1 | ||
* FWT2 11p15.5 [[loci]] | * FWT2 11p15.5 [[loci]] | ||
| | | style="background:#F5F5F5;" align="left" |[[Ultrasound]]: | ||
*The best initial [[Diagnostic study of choice|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]]: | ||
| Line 112: | Line 112: | ||
*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]] | ||
| Line 126: | Line 126: | ||
**[[Fibrous connective tissue|Fibrous tissue.]] | **[[Fibrous connective tissue|Fibrous tissue.]] | ||
|- | |- | ||
! | ! 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]] | * Include [[ewing sarcoma]], askin [[tumor]], and peripheral [[Neuroectodermal tumor primitive|neuroectodermal tumors primitive]] | ||
* The second most common [[childhood]] [[malignant]] primary [[bone]] [[tumors]] | * The second most common [[childhood]] [[malignant]] primary [[bone]] [[tumors]] | ||
* Usually arises in the long [[bones]] of the [[extremities]] | * Usually arises in the long [[bones]] of the [[extremities]] | ||
* Common [[age]] between 10-20 years old | * Common [[age]] between 10-20 years old | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
| | | style="background:#F5F5F5;" align="left" | + | ||
| | | | ||
* [[Weight loss]] | * [[Weight loss]] | ||
* [[Fatigue]] | * [[Fatigue]] | ||
|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* [[Fever]] | * [[Fever]] | ||
* [[Pathological|Pathologic]] [[fractures]] | * [[Pathological|Pathologic]] [[fractures]] | ||
* [[Petechiae]]/ [[purpura]] | * [[Petechiae]]/ [[purpura]] | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* [[Reciprocal translocation]] between [[chromosomes]] 11 and 22 | * [[Reciprocal translocation]] between [[chromosomes]] 11 and 22 | ||
| | | 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 of choice|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 (integral)|primitive]] appearing [[Cells (biology)|cells]] | * Regular sized [[Primitive (integral)|primitive]] appearing [[Cells (biology)|cells]] | ||
|- | |- | ||
! | ! 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) | +([[Abdominal]]) | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* [[Proptosis]] | * [[Proptosis]] | ||
* Periorbital ecchymosis | * Periorbital [[ecchymosis]] | ||
* Horner syndrome | * [[Horner syndrome]] | ||
* Opsoclonus myoclonus syndrome | * [[Opsoclonus myoclonus syndrome]] | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* | * [[Chromosome]] 1p [[Deletion (genetics)|deletion]] | ||
* N-myc amplification | * [[N-myc-interactor|N-myc]] [[amplification]] | ||
| | | style="background:#F5F5F5;" align="left" |[[CT scan]]: | ||
* Heterogeneous mass | * [[Heterogeneous]] [[mass]] | ||
* | * [[Calcification]] | ||
* Necrotic areas | * [[Necrotic]] areas | ||
MRI: | [[MRI]]: | ||
*T1: | *[[T1]]: | ||
** heterogeneous mass | ** [[heterogeneous]] [[mass]] | ||
*T2: | *[[Magnetic resonance imaging|T2]]: | ||
** | ** [[Heterogeneous]]/ hyperintense | ||
** | ** [[Cystic]]/ [[necrotic]] areas | ||
*C+ (Gd): | *C+ (Gd): | ||
** Heterogeneous mass | ** [[Heterogeneous]] [[mass]] | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* Well defined/ infiltrative mass | * Well defined/ infiltrative [[mass]] | ||
* Homer wright rosettes | * Homer [[Wright stain|wright]] rosettes | ||
* Secretion of vanillylmandelic acid (VMA) and homovanillic acid (HVA) | * [[Secretion]] of [[vanillylmandelic acid]] (VMA) and [[homovanillic acid]] (HVA) | ||
|- | |- | ||
! | ! 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]] | ||
| | | style="background:#F5F5F5;" align="left" |<nowiki>-</nowiki> | ||
| | | style="background:#F5F5F5;" align="left" |<nowiki>+/-</nowiki> | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* Headache | * [[Headache]] | ||
* | * [[Sweating]] | ||
* Weakness | * [[Weakness]] | ||
* Convulsion | * [[Convulsion]] | ||
| | | 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]] | ||
| | | 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 | ||
*T2: | *[[MRI|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]] | ||
|- | |- | ||
! | ! 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]]) | ||
| | | 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 | ||
|- | |- | ||
! | ! 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 | * 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 | * Rarely seen in adolescents and [[age]] of < 8 years old | ||
* [[Average]] [[age]] is 50 years among adults | |||
Average age is 50 years among adults | * Occur mostly in [[lower extremities]], [[retroperitoneal]] region, and [[shoulder]] | ||
| style="background:#F5F5F5;" align="left" | + | |||
Occur mostly in lower extremities, retroperitoneal region, and shoulder | | style="background:#F5F5F5;" align="left" | +/- | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* [[Weight loss]] | |||
| | * [[Fatigue]] | ||
* Weight loss | | style="background:#F5F5F5;" align="left" | - | ||
* Fatigue | | 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]] | ||
| | | 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 | * 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 | ||
| | | style="background:#F5F5F5;" align="left" |Divided into following subtypes: | ||
* Well-differentiated | * Well-differentiated | ||
* Dedifferentiated, Myxoid/ | * Dedifferentiated, Myxoid/ round [[cell]] | ||
* Pleomorphic | * [[Pleomorphic]] | ||
Common findings: | Common findings: | ||
* Lipoblasts presence | * Lipoblasts presence | ||
* Cytoplasmic lipid vacuoles | * [[Cytoplasmic]] [[lipid]] [[vacuoles]] | ||
* Chromatin spikes | * [[Chromatin]] spikes | ||
|- | |- | ||
! | ! 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]] | ||
| | | style="background:#F5F5F5;" align="left" | +/- ( [[Abdominal]] [[mass]], [[mediastinal]] [[mass]]) | ||
| | | 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: | ||
*t(8;21) | *t (8;21) | ||
*t(3;21) | *t (3;21) | ||
*t(15;17) | *t (15;17) | ||
| | | style="background:#F5F5F5;" align="left" |[[Radiography]]: | ||
*Chest radiography: | *[[Chest]] [[radiography]]: | ||
** Diagnosis of mediastinal mass | ** [[Diagnosis]] of [[mediastinal]] [[mass]] | ||
*Extremities radiography: | *[[Extremities]] [[radiography]]: | ||
** Metaphyseal bands | ** [[Metaphyseal]] [[bands]] | ||
** Lytic lesions | ** [[Lytic]] [[lesions]] | ||
** New periosteal bone formation | ** New [[Periosteal reaction|periosteal]] [[bone]] formation | ||
** Pathologic fractures | ** [[Pathological|Pathologic]] [[fractures]] | ||
CT scan/ MRI: | [[CT scan]]/ [[MRI]]: | ||
* Thickening/ edema of the bowel wall in presence of abdominal pain or | * Thickening/ [[edema]] of the [[bowel]] wall in presence of [[abdominal]] [[pain]] or [[bowel]] [[infection]] | ||
* Detection of early sinusitis | * Detection of early [[sinusitis]] | ||
* Intracranial hemorrhage in presence of neurological symptoms | * [[Intracranial hemorrhage|Intracranial]] [[hemorrhage]] in presence of [[neurological]] [[symptoms]] | ||
Radionuclide imaging: | [[Radionuclide test|Radionuclide]] [[imaging]]: | ||
* Detection of occult infection | * [[Detection theory|Detection]] of [[occult]] [[infection]] | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* Hyperplastic bone marrow with leukemia cells replacement | * [[Hyperplastic]] [[bone marrow]] with [[leukemia]] [[Cells (biology)|cells]] replacement | ||
* Megaloblastic feature | * [[Megaloblastic Anemias|Megaloblastic]] feature | ||
* | * Decrease in [[normal]] [[hematopoietic cell]] | ||
|- | |- | ||
! | ! 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, | * 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 | * [[Bone marrow]] replaced with [[malignant]] [[lymphoblasts]] | ||
| | | style="background:#F5F5F5;" align="left" | | ||
+/-( Extramedullary | +/-( Extramedullary [[mass]] in [[abdomen]]/ [[head]]/ [[neck]]) | ||
| | | style="background:#F5F5F5;" align="left" | +/- ([[Musculoskeletal]] [[pain]]) | ||
| | | style="background:#F5F5F5;" align="left" | | ||
* Weakness | * [[Weakness]] | ||
* Fatigue | * [[Fatigue]] | ||
* Weight loss | * [[Weight loss]] | ||
* | * [[Bleeding]] | ||
| | | style="background:#F5F5F5;" align="left" | - | ||
| style="background:#F5F5F5;" align="left" | | |||
* Fever | * [[Fever]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
* [[Pallor]] | * [[Pallor]] | ||
* [[Papilledema]] | * [[Papilledema]] | ||
| Line 406: | Line 404: | ||
* [[Cranial nerve palsy]] | * [[Cranial nerve palsy]] | ||
* [[Dyspnea]] | * [[Dyspnea]] | ||
| | | 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) | ||
| | | style="background:#F5F5F5;" align="left" |[[Radiography]]: | ||
Chest x ray: | [[Chest]] [[x ray]]: | ||
* Nodular | * [[Nodular]] [[mass]] | ||
* Central lymphadenopathy | * [[Central]] [[lymphadenopathy]] | ||
Bone x ray: | [[Bone]] [[x ray]]: | ||
* Radiolucent metaphyseal bands | * Radiolucent [[metaphyseal]] [[bands]] | ||
* Coarse trabeculation | * Coarse trabeculation | ||
* Periosteal | * [[Periosteal reaction]] | ||
* Osteopenia | * [[Osteopenia]] | ||
Brain MRI: | [[Brain]] [[MRI]]: | ||
* Leukoencephalopathy | * [[Leukoencephalopathy]] | ||
* Glial cell hyperplasia | * [[Glial cell]] [[hyperplasia]] | ||
* Meningitis | * [[Meningitis]] | ||
| | | 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]] | ||
|- | |- | ||
! | ! 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" | | ||
* Cancer derives from lymphocytes | * [[Cancer]] derives from [[lymphocytes]] | ||
* | * Diverse [[age]] of incidence | ||
* Associated with autoimmune disorders, previous cancer therapy, and infection | * Associated with [[autoimmune disorders]], previous [[cancer]] [[therapy]], and [[infection]] | ||
| | | style="background:#F5F5F5;" align="left" | + | ||
| style="background:#F5F5F5;" align="left" | - | |||
| style="background:#F5F5F5;" align="left" | | |||
* Lymph node swelling | * [[Lymph node]] [[swelling]] | ||
* Weight loss | * [[Weight loss]] | ||
* Anorexia | * [[Anorexia]] | ||
* Abdominal pain | * [[Abdominal]] [[pain]] | ||
* Nausea/ | * [[Nausea]]/ [[vomiting]] | ||
| | | style="background:#F5F5F5;" align="left" | + ([[Chest]] [[tenderness]]) | ||
| | | style="background:#F5F5F5;" align="left" | | ||
Hepatosplenomegaly | * [[Fever]] | ||
Lymphadenopathy | * [[Hepatosplenomegaly]] | ||
Seizure | * [[Lymphadenopathy]] | ||
Petechiae | * [[Seizure]] | ||
| | * [[Petechiae]] | ||
| style="background:#F5F5F5;" align="left" | | |||
* [[MLL2]] | * [[MLL2]] | ||
* [[MEF2B]] | * [[MEF2B]] | ||
| Line 465: | Line 464: | ||
* [[KMT2D]] | * [[KMT2D]] | ||
* [[CDKN2A]] | * [[CDKN2A]] | ||
| | | style="background:#F5F5F5;" align="left" |[[Radiography]]: | ||
*Chest x ray: | *[[Chest]] [[x ray]]: | ||
** Central lymphadenopathy | ** [[Central]] [[lymphadenopathy]] | ||
** Pleural effusion | ** [[Pleural effusion]] | ||
** Pericardial effusion | ** [[Pericardial effusion]] | ||
CT scan: | [[CT scan]]: | ||
* Presence of enlarged lymph node in chest, abdomen, and pelvis | * Presence of enlarged [[lymph node]] in [[chest]], [[abdomen]], and [[pelvis]] | ||
Ultrasound: | [[Ultrasound]]: | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
| | | style="background:#F5F5F5;" align="left" |[[Histology]] findings of [[Non-Hodgkin lymphoma|non-hodgkin]] [[lymphoma]] depend on: | ||
* Cell differentiation | * [[Cell]] [[differentiation]] | ||
* Cell lineage | * [[Cell]] [[Lineage (evolution)|lineage]] | ||
* Location of cell origin | * 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
- Rhabdomyosarcoma must be differentiated from following diseases:
| Disease | History/demography | Symptoms | Physical examination | Diagnosis | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Palpable mass | Pain | Others | Mass tenderness | Others | Genetics | Imaging | Histology | |||
| Rhabdomyosarcoma[1][2][3][4] |
|
+ | + |
|
+/- |
Mutations in: |
CT scan:
MRI:
|
| ||
| Wilms tumor[5][6][7][8][9] |
|
+ | + |
|
+/- | Present mutations of: | Ultrasound:
|
| ||
| Ewing sarcoma[10][11][12][13] |
|
+ | + | + |
|
Radiographic of region:
MRI:
|
| |||
| Pediatric neuroblastoma [14][15][16][17] |
Age distribution:
|
+ (Abdominal) |
+ |
+(Abdominal) |
CT scan:
MRI:
|
| ||||
| Pediatric pheochromocytoma[18][19][20][21] |
|
- | +/- | - | Genetic mutation in: | Ultrasound:
|
Positive stains for:
| |||
| Pediatric osteosarcoma[22][23][24] |
|
+ | + | + |
|
|
Radiography:
MRI: |
| ||
| Pediatric liposarcoma[25][26][27][28] |
|
+ | +/- | - |
|
|
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:
|
Radiography:
|
| |||
| Pediatric acute lymphoblastic leukemia[33][34] |
|
+/- (Musculoskeletal pain) | - | Chromosomal translocations:
|
Radiography:
|
Divided into 3 subgroups:
L1:
L2:
L3:
| ||||
| Pediatric non-hodgkin lymphoma[35][36][37] |
|
+ | - | + (Chest tenderness) | Radiography:
|
Histology findings of non-hodgkin lymphoma depend on: | ||||
References
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- ↑ Yarmish G, Klein MJ, Landa J, Lefkowitz RA, Hwang S (2010). "Imaging characteristics of primary osteosarcoma: nonconventional subtypes". Radiographics. 30 (6): 1653–72. doi:10.1148/rg.306105524. PMID 21071381.
- ↑ Araki N, Uchida A, Kimura T, Yoshikawa H, Aoki Y, Ueda T; et al. (1991). "Involvement of the retinoblastoma gene in primary osteosarcomas and other bone and soft-tissue tumors". Clin Orthop Relat Res (270): 271–7. PMID 1884549.
- ↑ Shmookler BM, Enzinger FM (1983). "Liposarcoma occurring in children. An analysis of 17 cases and review of the literature". Cancer. 52 (3): 567–74. PMID 6861094.
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- ↑ Orazi A (2007). "Histopathology in the diagnosis and classification of acute myeloid leukemia, myelodysplastic syndromes, and myelodysplastic/myeloproliferative diseases". Pathobiology. 74 (2): 97–114. doi:10.1159/000101709. PMID 17587881.
- ↑ Zuckerman T, Rowe JM (2014). "Pathogenesis and prognostication in acute lymphoblastic leukemia". F1000Prime Rep. 6: 59. doi:10.12703/P6-59. PMC 4108947. PMID 25184049.
- ↑ Pui CH, Robison LL, Look AT (2008). "Acute lymphoblastic leukaemia". Lancet. 371 (9617): 1030–43. doi:10.1016/S0140-6736(08)60457-2. PMID 18358930.
- ↑ Green MR, Gentles AJ, Nair RV, Irish JM, Kihira S, Liu CL; et al. (2013). "Hierarchy in somatic mutations arising during genomic evolution and progression of follicular lymphoma". Blood. 121 (9): 1604–11. doi:10.1182/blood-2012-09-457283. PMC 3587323. PMID 23297126.
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