Diagnosis Of Soft Tissue Lesions Research Articles

Primary Hydatid Cysts in the Extremities: A Systematic Review of the Literature.

Primary hydatid cysts (PHCs) in the extremities are uncommon, presenting in the majority of cases with atypical clinical features. Radical surgical excision remains the mainstay of treatment. The aim of our study was to accumulate the already published data on PHCs in the extremities in terms of demographic, diagnostic, and therapeutic aspects. Three electronic databases were meticulously searched for articles published until 2024. A total of 85 studies comprising 118 patients were finally included in our review. Sixteen patients (13.5%) were diagnosed with a hydatid cyst in their upper extremity, 94 (79.7%) with a PHC in the lower extremity, and eight (6.8%) with an echinococcal cyst in the axilla. Pain and swelling were the most frequent symptoms, whereas only two patients were completely asymptomatic. The mean lesion size was 11.6 ± 7.1 cm.Preoperative serology investigation was reported in 82 out of 118 (69.5%) patients; among them, 33 (44.6%) cases had a positive preoperative serology test. The vast majority of patients (96.6%) were treated with an interventional procedure either surgical or radiological, and only seven experienced postoperative complications. No anaphylactic reaction was described perioperatively. Although preoperative diagnosis of PHCs is challenging, they should be considered in the differential diagnosis of soft tissue lesions. Treatment strategies should be individualized on a patient basis, while radical surgical excision remains the gold standard treatment.

Demographic and histopathologic study of soft tissue lesions in a tertiary care hospital in South India

The term soft tissue tumors (STT) encompass a wide range of tumors arising from the mesenchymal tissues. In this study, we have retrospectively analysed the various STTs occurring in the Department of Pathology and included all cases with a confirmed histopathological diagnosis of soft tissue lesions received during the study period of January 2018 – December 2019. These cases were further analysed for the site of the lesion, number of lesions, age and gender of the patients and the results tabulated. A total of 207 cases of soft tissue tumors with confirmed histopathological diagnosis were included in this study. The male: female ratio was 1.1:1. It was observed that most of the soft tissue tumors were seen in the 31-40 years age group (33%) followed by the 41-50 years age group (21%). The most common histopathologic subtype of tumors were of adipocytic origin (61%). Malignant morphology was observed in 2.4% of the cases. Soft tissue tumors are not uncommon tumors and account for 5.2% of cases among the routine histopathological specimens. This study is presented here to understand the demography and the spectrum of soft tissue tumors observed in a tertiary care centre.

STUDY OF CYTOMORPHOLOGICAL FEATURES OF MYXOID SOFT TISSUE LESIONS BY FINE NEEDLE ASPIRATION CYTOLOGY

Fine needle aspiration cytology (FNAC) was initially conceived as a means to confirm a clinical suspicion of local recurrence or metastasis of known cancer without subjecting the patient to further surgical intervention.[1] In 1998, Akerman M highlighted the benefits of FNA when compared with core needle or open surgical biopsy.The most important were rapid preliminary diagnosis, no need for hospitalization and anaesthesia, negligible complications and fear for tumour cell spread.[2] Soft tissue can be defined as nonepithelial extra skeletal tissue of the body exclusive of the reticuloendothelial system, glia,and supporting tissue of various parenchymal organs.[3] Myxoid tumours of soft tissue are a heterogeneous group of tumours characterized by their abundant mucoid/myxoid extracellular matrix. [4] Soft tissue tumors (STT) is a very wide area of interest , but cytologically,relatively less discovered.[5] FNAC is relatively painless,produces a speedy result and is a cheap procedure and has a good sensitivity and specificity in diagnosing primary and metastatic STT.[6] Except to categorise STT, FNAC is proved effective in differentiating benign and malignant STTs.[7] Aim of the present study was to assess the spectrum of Soft tissue lesion with myxoid change on cytology and to estimate the sensitivity and specificity of FNAC in diagnosis of soft tissue lesions with myxoid change.

A STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY SMEARS OF UPPER AND LOWER LIMB SOFT TISSUE LESIONS.

BACKGROUND: Soft tissue tumours constitute a large and heterogeneous group of neoplasms. Most soft tissue tumors in the upper extremity are benign, and soft tissue sarcomas are rare in the hand and wrist. Supercial soft-tissue masses are among the most common indications for imaging of the extremities. A broad array of benign and malignant processes may be manifested in palpable cutaneous or subcutaneous masses or nodules. In tertiary care set up both imaging and FNAC can play a vital role in preliminary diagnosis of soft tissue lesions of the extremities by differentiating them from cutaneous vs. non cutaneous, osseous vs. non osseous tumors. METHODS: A prospective study was conducted in the Department of Pathology, Government general hospital Nizamabad, Telangana ,during March 2017 to March 2019 that evaluated 50 patients with history of swelling in upper and lower limb had been evaluated . Detailed history, thorough clinical examination, Imaging, Fine needle aspiration cytology was performed in all the 50 Patients. Aspiration smears were stained with Hematoxylin and Eosin and microscopic examination done. RESULT: The patients aged from 10 to 75 years, average age at presentation was 41.2 yrs. Of total 50 cases 27 were upper limb (54%) and 23(46%) were lower limb lesions. Of both upper limb and lower limb lesions, Lipoma constituted most common lesion 20 cases(40%) with 16 cases of total 27 cases in upper limb (59%) making it most common benign soft tissue lesion in the upper limb. 4 cases(8%) out of 50 cases were diagnosed as spindle cell lesion undetermined/sarcoma and advised histo-pathological evaluation. CONCLUSION: A detailed evaluation of patients presenting with swelling in the upper and lower limb coupled with imaging and FNAC, in establishing the diagnosis required for further follow action was done. In most of the cases imaging coupled with FNAC gave better results but in some it required histo-pathological evaluation. FNAC was found to be an better modality for preliminary diagnosis along with radiology in decision making process for further surgical approach.

Oral focal mucinosis: A multi-institutional study and literature review.

Oral focal mucinosis (OFM) is a rare benign condition of unknown etiology, considered the oral counterpart of cutaneous focal mucinosis. We report the clinicopathologic features of 21 cases of OFM in conjunction with a review of the literature. Clinical data were collected from the records of five oral and maxillofacial pathology services. All cases were evaluated by hematoxylin and eosin staining, histochemistry, and immunohistochemistry (vimentin, S-100, α-SMA, CD34, and mast cell). The series comprised 14 females (66.7%) and seven males (33.3%), with a mean age of 48.2 ± 20.7 years (range: 8-77 years) and a 2:1 female-to-male ratio. Most of the lesions affected the gingiva (n = 6, 28.6%) and presented clinically as asymptomatic sessile or pedunculated nodules with fibrous or hyperplasic appearance. All cases were negative for S-100 protein, CD34, and α-SMA and positive for Alcian blue staining. Conservative surgical excision was the treatment in all cases, and there was only one recurrence. OFM is a rare benign disorder that is often clinically misdiagnosed as reactive lesions or benign proliferative processes. Dermatologists and pathologists should consider OFM in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located in the gingiva.

Soft tissue tumor diagnosis: A three prong approach utilizing pattern analysis, immunocytochemistry, and molecular diagnostics.

Tissue diagnosis of a soft tissue neoplasm is of paramount importance for the development of an appropriate treatment plan. Biopsy technique including approach and biopsy method is important to the success of diagnosis and subsequent treatment. Histologic and cytologic diagnoses are difficult and complicated by the large number of soft tissue lesions described, distinctly different biopotential for morphologically similar lesions, often small biopsy specimen size, and the generally limited experience many pathologists have in the diagnosis of soft tissue neoplasms. While utilized less frequently than core-needle biopsies, fine-needle aspiration is a valuable initial approach for the classification of soft tissue neoplasms. The combination of pattern based morphologic analysis, immunohistochemistry, and molecular diagnostics represents a utilitarian and generally successful approach for the diagnosis of soft tissue lesions.

APPLICATION OF VAC-THERAPY IN THE TREATMENT OF DIABETIC FOOT

The aim. To substantiate the effectiveness of the use of VAC-therapy in the treatment of wounds in patients with diabetic foot syndrome. Materials and methods. The patient with a complicated form of diabetic foot syndrome was examined. The monitoring of the course of the wound process is supplemented by clinical, cytological, microbiological and morphological criteria. In the treatment of patients we used vacuum therapy apparatus. Vacuum wound therapy was performed in negative pressure regimens in the range of 80–125 mm Hg. Results. In the pattern of morbidity in economically developed countries, diabetes mellitus (DM) occupies one of the first places. Its prevalence is 1.5–6 %. The number of patients with diabetes in Ukraine is likely to reach 14 million by 2020. Lesions of the lower extremities of different genesis occur in 30–80 % of people with impaired carbohydrate metabolism. Most often, these lesions are complicated by the development of chronic peptic ulcer defects, which, when untimely diagnosed and inadequate treatment, leads to amputation of the affected limb. Even when radical surgery is avoided, the long and costly treatment of trophic disorders of the soft tissues of the feet and legs leads to huge costs of both material resources and time for medical staff. In 15 % of patients with DM, trophic ulcers of the lower extremities are diagnosed. Recent studies have focused on such important aspects of the study of this issue as the early diagnosis of soft tissue lesions in individuals with DM, the development of treatment aimed at preventing amputations, facilitating the further rehabilitation of patients. Vacuum therapy is one of the new methods of treating wound defects, including in patients with diabetic foot syndrome. Topical application of vacuum therapy has already become an integral therapeutic option for wound debridement in patients with diabetic foot syndrome. However, when applying the classic vacuum therapy technique, these patients have the problem of delaying the outflow of tissue exudate and lysis detritus to the vacuum system. Conclusions. Optimization of the technique of the influence of negative pressure on the wound by applying forced drainage with irrigation of the wound with an antiseptic can maintain a constantly high concentration of antimicrobial agent in the wound, increase the speed of wound dialysis and prevent clogging of pores of the sponge and the bacterial colonies in it. The application of this technique avoids high amputation, accelerates the time of wound healing, and retains the supporting function of the lower extremity.

Accuracy of core biopsies for the diagnosis of soft tissue lesions at a tertiary hospital laboratory in Western Australia

Accuracy of core biopsies for the diagnosis of soft tissue lesions at a tertiary hospital laboratory in Western Australia

Clinicopathological diagnostic discrepancies: An analysis of 1703 surgical pathology specimens

Background: Evaluation of error occurrence is a vital component of laboratory-quality assurance. One method of the measuring errors is by an assessment of discrepancies in clinical and pathology diagnosis. This study was carried out to determine the occurrence of such differences in our institution and to find out if any association exists between clinical diagnostic reasoning and the nature of the lesion. Materials and Methods: A 3-year retrospective analysis of surgical pathology specimen records was performed for report contents, clinical diagnosis, clinical suspicion, or diagnostic questions. Discrepancy index (Di) was calculated as the number of incompatible cases/total number of cases ×100. Results: An analysis of 1703 cases showed complete agreement between the clinical and pathology diagnosis in majority of the cases (1514, 89.9%) while discordance occurred in 189 (11.1%). There was more discrepancy in benign cases (12.3%, n = 1144) than malignant conditions (8.6%, n = 559). Using Chi-square test of independence, there was association between the nature of the lesion (benign or malignant) and diagnostic concordance (χ2 = 5.24, P = 0.02207) at 0.01 level of significance. There was more discordance in diagnosis of soft tissue lesions (Di = 23.8, n = 1587). Conclusion: This study suggests that greater discrepancies are likely to occur in the diagnoses of benign conditions than malignant diseases.

Primary Hydatidosis of Vastus Lateralis

Hydatid cyst disease is common in some regions of the world and is usually located in liver and lung, but it can be seen any where in the body. this report presents a case of primary hydatid disease located partially Subcutaneosuly and partially intramuscular in the vastus lateralis.Case presentation :A 38-year-old male laborer Presented to our hospital with a slow growing swelling in the lateral aspect of his thigh for the last 6 months. Ultrasound and MRI revealed a lesion resembling hydatid cyst. The patient did not have a history of hydatid cyst disease and hydatid cysts were not detected in other organs. Total excision of cyst was done and the pathological examination confirmed the diagnosis.Conclusion :Muscular hydatidosis should be considered in the differential diagnosis of soft tissue lesions in endemic areas. Total excision of the cyst with an intact wall is the best treatment.

Fine Needle Aspiration Cytology Diagnosis of Soft Tissue Lesions in a Large Pediatric Hospital

Fine Needle Aspiration Cytology Diagnosis of Soft Tissue Lesions in a Large Pediatric Hospital

Evaluation of Molecular and Immunohistochemical Adjunct Modalities in the Diagnosis of Soft Tissue Neoplasms.

The accurate diagnosis of soft tissue neoplasms has crucial therapeutic and prognostic importance. There is frequent morphologic overlap between entities, and ancillary modalities are used in the vast majority of diagnoses. Immunohistochemistry is rapid and inexpensive, and in addition to the older markers that mainly detected cytoplasmic proteins, antibodies can indirectly detect tumor-specific genetic and molecular abnormalities. The use of molecular diagnostic techniques is now widespread, with molecular services often integrated into routine histopathology laboratories; as their cost and turnaround times begin to parallel those for immunohistochemistry, we compared the usefulness of ancillary immunohistochemistry, molecular genetic, and molecular cytogenetic techniques in the diagnosis of soft tissue lesions. We evaluated the number and contribution of immunohistochemical tests and panels and of ancillary molecular techniques in the primary histopathologic diagnosis of 150 soft tissue lesions. Ninety of 150 cases required either only one immunohistochemical panel or minimal immunohistochemistry for diagnosis, while 39/150 required 2 to 4 panels. In 5/150, ancillary molecular tests alone (without immunohistochemistry) were diagnostically sufficient. The majority of cases required one immunohistochemical panel for diagnosis, with a smaller proportion requiring a second, and a minority requiring a third or fourth (which mainly comprised neoplasms for which the final diagnosis was uncertain). Certain neoplasms required both extensive immunohistochemistry and ancillary molecular testing, despite which the final diagnosis was inconclusive. Ancillary molecular techniques now make a significant contribution to soft tissue tumor diagnosis, being required in over one third (52/150) of cases, and were useful in confirming or excluding tumors that were not possible to conclusively diagnose with histology and immunohistochemistry. Only a small proportion of soft tissue neoplasms (16/150; all benign) did not require immunohistochemistry or ancillary molecular methods, with morphology alone being sufficient for diagnosis.

Rapidly-growing buccal mass in a 6-month-old infant

Lipoblastoma and lipoblastomatosis are rare benign tumours of fetal-embryonal adipocytes that usually present in young children, which is why they are not often included in the differential diagnosis of soft tissue lesions in infants. We describe a case of a 6-month-old infant with an intraoral buccal lipoblastoma.

Use of office-based ultrasonography for soft tissue lesions : A report of 3 cases with literature review

Ultrasonography is relatively inexpensive, non-invasive imaging tool and provides real-time imaging. In addition, the images can be obtained repeatedly. But it is not widely used by dentists because it is hard to interpret and technique sensitive. Above all, ultrasonography cannot be used for hard tissue diagnosis. However, ultrasonography can be applied for diagnosis of infection, soft tissue tumor and inflammatory muscle diseases which are commonly found in dental outpatients. Generally, it shows well-defined border, hypoechoic and homogenous structure in case of benign tumor. Malignant tumor appears relatively irregular margin and heterogenous structure. Cyst represents relatively echo-free features compared with benign tumor. Although the general characteristics of abscess are similar with benign tumor, we can observe an increased vascularity and different clinical features. The purpose of this report is to present 3 cases of US images using office-based ultrasonography with their features and discuss the role of office-based ultrasound in dentistry for diagnosis of soft tissue lesions with literature review.

Primary localized amyloidoma of abdominal wall presenting as abscess: Rare case

The deposition of amyloid as a distinct, clinically apparent mass is uncommon particularly in the soft tissues. There have been no previously published case reports of abdominal wall involvement; thereby we are describing a case of AA amyloidoma which presented as an abdominal wall abscess without any evidence of systemic disease. The clinical and radiological findings suggested soft tissue abscess likely cysticercosis or a neoplastic process. This case demonstrates the importance of considering the possibility of amyloidoma in the differential diagnosis of soft tissue lesions.

The use of computed tomography to diagnose bilateral forelimb tendon pathology in a horse with unilateral lameness

SummaryA horse with unilateral forefoot lameness had bilateral deep digital flexor tendon (DDFT) lesions on computed tomography (CT). Venous contrast enhanced CT revealed distal sesamoidean impar desmitis in the lame forelimb. Computed tomography is useful for diagnosis of soft tissue lesions within the hoof capsule and contrast enhancement improves lesion conspicuity.

Ultrasonography - A diagnostic modality for oral and maxillofacial diseases.

Background:Many diseases present themselves in oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intraoral and panoramic radiography, ultrasonography (USG), computer tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, USG is easy to-use for the detection of non-invasive and soft tissue related diseases in oral and maxillofacial regions. USG plays an important role in analyzing normal and abnormal structures. In particular, in oral and maxillofacial regions, the USG may be clinically applied to evaluate lymph nodes, subcutaneous, and oral cavity-related diseases.Aims:The aim was to correlate the findings of USG and histopathology for the diagnosis of oral and maxillofacial pathology and to evaluate whether USG can be used as an adjunct in diagnosing oral and maxillofacial pathology.Materials and Methods:A total of 10 clinically diagnosed patients with intraoral cancerous growths, swellings in maxillary and neck region were included in this study. Incision biopsy was obtained for confirming provisional clinical diagnosis. The selected cases were advised USG. All patients were then posted either for hemi-glossectomy, hemi-mandibulectomy, and partial maxillectomy with or without radical neck dissection.Statistical Analysis:Student's t-test and coefficient of correlation was used to statistically analyze significant relationship of both the methods.Result:In all 10 cases, USG correlated well with histopathology findings, it could also delineate tumor extent and measure tumor thickness.Conclusion:USG is an excellent method for the diagnosis of soft tissue lesions and can be used as an adjunct in diagnosing oral and maxillofacial pathology.

Role of Ultrasound in the Diagnosis of Common Soft Tissue Lesions of the Limbs

The objective of this study was to investigate the role of ultrasound in the diagnosis of the soft tissue lesions of the limbs. Database of the soft tissue lesions of the limbs were reviewed retrospectively. All lesions had been confirmed by histopathology after surgical removal or biopsy. Ultrasound examination of the patients was performed by 4 sonologists with 9 to 22 years of experience, and the results were reviewed by 2 sonologists in panel. Categories and characteristics of some soft tissue lesions of the limbs were studied. Concordance rate was calculated, and reasons of misdiagnosis were analyzed. The patients consisted of 224 males and 173 females, and the age range was 6 months to 74 years (mean, 29.1 ± 27.3 years). The soft tissue lesions of the limbs included granuloma, inflammatory lesions, hematoma, hemangioma, neurofibroma, lipofibromatous hamartoma, fibrosarcoma, lymphangioma, liposarcoma, Baker cyst, epidermoid cyst, angiolipoma, fibrolipoma, malignant schwannoma, dermoid cyst, and intramuscular myoma. Fibrous tumor, lipoma, and hemangioma are of higher proportion. Baker cyst and neurofibroma were more often diagnosed correctly. Malignant lesions liposarcoma and malignant schwannoma were all misdiagnosed. A large number of misdiagnosed lesions were misdiagnosed as fibroma or lipoma. The overall concordance rate of sonographic diagnosis was 57.7%. Of the soft tissue lesions of the limbs, Baker cyst and neurofibroma are more often diagnosed correctly, and definitive diagnosis of other lesions is challenging. The overall concordance rate of sonographic diagnosis is not satisfactory.

MR imaging diagnostic protocol for unilocular lesions of the jaw

Ameloblastomas and keratocystic odontogenic tumors (KCOT) are typical jawbone tumors. In addition, dentigerous cysts (DC) and radicular cysts are the most common cystic jawbone lesions, and simple bone cysts (SBC) are the most common jawbone pseudocysts. When these lesions are unilocular, it can be difficult to diagnose them by radiography. In recent years, adding magnetic resonance (MR) imaging to obtain information about soft tissue has been shown to improve the accuracy of jawbone lesion diagnosis. We also have reported MR imaging features of jawbone lesions. However, no systematic method for MR imaging diagnosis of jawbone lesions has been reported. In this review, we examine unilocular lesions such as ameloblastoma, KCOT, adenomatoid odontogenic tumour (AOT), DC, and SBC. First, we describe the MR imaging features of each lesion. Then, we describe our novel MR imaging diagnostic protocol. Using our MR imaging diagnostic protocol to diagnose 31 cases, we obtained a positivity rate of 71.0%. The use of our MR imaging diagnostic protocol for unilocular lesions, which are especially difficult to differentiate by radiography, would improve the morphological and qualitative diagnosis of soft tissue lesions.

Diagnosis of soft tissue lesions involving the equine head

Diagnosis of soft tissue lesions involving the equine head