Imaging of Soft Tissue Tumors pp 187-196 | Cite as
WHO Classification of Soft Tissue Tumors
Abstract
Soft tissue tumors (STT) represent a complex group of lesions that may show a broad range of differentiation. The WHO (World Health Organization) classification has been up-to-dated in 2013 for the purpose of uniformity. The major modifications from the previous edition are the addition of three new chapters: gastrointestinal stromal tumors (GIST), nerve sheath tumors, and undifferentiated/unclassified sarcomas. The classification includes the following groups: (1) adipocytic tumors, (2) fibroblastic/myofibroblastic tumors, (3) so-called fibrohistiocytic tumors, (4) smooth muscle tumors, (5) pericytic (perivascular) tumors, (6) skeletal muscle tumors, (7) vascular tumors, (8) gastrointestinal stromal tumors, (9) nerve sheath tumors, (10) chondro-osseous tumors, (11) tumors of uncertain differentiation and (12) undifferentiated/unclassified sarcomas.
This chapter reviews the main features of the classification with the major changes within the different categories of soft tissue tumors. The WHO classification might serve as a guide for radiologists working in a multidisciplinary committee with clinicians, surgeons, and pathologists.
Keywords
Gastrointestinal Stromal Tumor Synovial Sarcoma Solitary Fibrous Tumor Nerve Sheath Tumor Smooth Muscle TumorReferences
- 1.Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F (eds) (2013) WHO classification of tumours of soft tissue and bone. IARC Press, LyonGoogle Scholar
- 2.Fletcher CDM, Unni KK, Mertens F (eds) (2002) WHO classification of tumours. Pathology and genetics of tumours of soft tissue and bone. IARC Press, LyonGoogle Scholar
- 3.Green AR, Cannon SR, Flanagan AM (2004) Chondroid lipoma: correlation of imaging findings and histopathology of an unusual benign lesion. Skeletal Radiol 33(11):670–673CrossRefPubMedGoogle Scholar
- 4.Erickson-Johnson MR, Chou MM, Evers BR, Roth CW, Seys AR, Jin L et al (2011) Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion. Lab Invest J Tech Methods Pathol 91(10):1427–1433CrossRefGoogle Scholar
- 5.Doyle LA (2014) Sarcoma classification: an update based on the 2013 world health organization classification of tumors of soft tissue and bone. Cancer 120(12):1763–1774CrossRefPubMedGoogle Scholar
- 6.Fletcher CDM (2014) The evolving classification of soft tissue tumours – an update based on the new 2013 WHO classification. Histopathology 64(1):2–11CrossRefPubMedGoogle Scholar
- 7.Rosenberg AE (2003) Malignant fibrous histiocytoma: past, present, and future. Skeletal Radiol 32(11):613–618CrossRefPubMedGoogle Scholar
- 8.Vilanova JC, Barcelo J, Smirniotopoulos JG, Perez-Andres R, Villalon M, Miro J et al (2004) Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 24(2):367–385CrossRefPubMedGoogle Scholar
- 9.Vanhoenacker FM, Camerlinck M, Somville J (2009) Imaging findings of a subcutaneous angioleiomyoma. JBR-BTR Organe Société R Belge Radiol SRBR Orgaan Van K Belg Ver Voor Radiol KBVR 92(2):80–82Google Scholar
- 10.Yoo HJ, Choi J-A, Chung J-H, Oh JH, Lee G-K, Choi J-Y et al (2009) Angioleiomyoma in soft tissue of extremities: MRI findings. AJR Am J Roentgenol 192(6):W291–W294CrossRefPubMedGoogle Scholar
- 11.Liang GS, Loevner LA, Kumar P (2000) Laryngeal rhabdomyoma involving the paraglottic space. AJR Am J Roentgenol 174(5):1285–1287CrossRefPubMedGoogle Scholar
- 12.Szuhai K, de Jong D, Leung WY, Fletcher CDM, Hogendoorn PCW (2014) Transactivating mutation of the MYOD1 gene is a frequent event in adult spindle cell rhabdomyosarcoma. J Pathol 232(3):300–307CrossRefPubMedGoogle Scholar
- 13.Tekes A, Koshy J, Kalayci TO, Puttgen K, Cohen B, Redett R et al (2014) S.E. Mitchell Vascular Anomalies Flow Chart (SEMVAFC): a visual pathway combining clinical and imaging findings for classification of soft-tissue vascular anomalies. Clin Radiol 69(5):443–457CrossRefPubMedGoogle Scholar
- 14.Hornick JL, Fletcher CDM (2011) Pseudomyogenic hemangioendothelioma: a distinctive, often multicentric tumor with indolent behavior. Am J Surg Pathol 35(2):190–201CrossRefPubMedGoogle Scholar
- 15.Guo T, Zhang L, Chang N-E, Singer S, Maki RG, Antonescu CR (2011) Consistent MYC and FLT4 gene amplification in radiation-induced angiosarcoma but not in other radiation-associated atypical vascular lesions. Genes Chromosomes Cancer 50(1):25–33CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Torigoe T, Yazawa Y, Takagi T, Terakado A, Kurosawa H (2007) Extraskeletal osteosarcoma in Japan: multiinstitutional study of 20 patients from the Japanese Musculoskeletal Oncology Group. J Orthop Sci Off J Jpn Orthop Assoc 12(5):424–429Google Scholar
- 17.Dow N, Giblen G, Sobin LH, Miettinen M (2006) Gastrointestinal stromal tumors: differential diagnosis. Semin Diagn Pathol 23(2):111–119CrossRefPubMedGoogle Scholar
- 18.Vilanova JC, Woertler K, Narvaez JA, Barcelo J, Martinez SJ, Villalon M et al (2007) Soft-tissue tumors update: MR imaging features according to the WHO classification. Eur Radiol 17(1):125–138CrossRefPubMedGoogle Scholar
- 19.Hornick JL, Bundock EA, Fletcher CDM (2009) Hybrid schwannoma/perineurioma: clinicopathologic analysis of 42 distinctive benign nerve sheath tumors. Am J Surg Pathol 33(10):1554–1561CrossRefPubMedGoogle Scholar
- 20.Feany MB, Anthony DC, Fletcher CD (1998) Nerve sheath tumours with hybrid features of neurofibroma and schwannoma: a conceptual challenge. Histopathology 32(5):405–410CrossRefPubMedGoogle Scholar
- 21.Stewart ST, McCarthy SM (2004) Case 77: aggressive angiomyxoma. Radiology 233(3):697–700CrossRefPubMedGoogle Scholar
- 22.Thway K, Fisher C (2014) Synovial sarcoma: defining features and diagnostic evolution. Ann Diagn Pathol 18(6):369–380CrossRefPubMedGoogle Scholar
- 23.Fletcher CDM (2008) Undifferentiated sarcomas: what to do? And does it matter? A surgical pathology perspective. Ultrastruct Pathol 32(2):31–36CrossRefPubMedGoogle Scholar
- 24.Reichardt P (2014) Soft tissue sarcomas, a look into the future: different treatments for different subtypes. Future Oncol Lond Engl 10(8 Suppl):s19–s27CrossRefGoogle Scholar