A lágyrészsarcomák patológiája

Abstract

Soft tissue sarcomas comprise around 1% of all malignant tumors, but they are relatively more frequent in childhood and adolescence. This latter fact emphasizes the need that timely diagnosis should be established for optimal treatment. The very recent WHO classification (2013) lays down the following main categories: adipocyte tumors, fibroblast/myofibroblast tumors, so-called fibrohistiocyte tumors, smooth-muscle tumors, pericyte tumors, skeletal-muscle tumors, vascular tumors, chondro-osseous tumors, gastrointestinal stromal tumors, nerve sheath tumors, tumors of uncertain differentiation and undifferentiated/unclassified sarcomas (including the former malignant fibrous histiocytoma). Beside the proper diagnosis it is also important to give the grade which basically determines the therapy. We use the French Federation of Cancer Centers Sarcoma Group (FNCLCC) grading system. The choice of preoperative diagnosis can be both fine needle and core biopsy and together with radiological image analysis they define the type of surgical intervention. The modern pathological diagnosis of soft tissue sarcomas is still based on the examination of H&E slides but it is also necessary to have a wide immunohistochemical panel and to use molecular methods for the sake of precise diagnosis and the broadening possibilities of targeted therapy.