Qap (Anatomical Pathology) 

QAP Peer Review

AP213
Case History: M/35, left thigh tumor
Intended diagnosis: Fibrosarcoma arising in DFSP, soft tissue. Contributed by:KFT
Code Diagnosis Comment Score
anonymous Fibrosarcoma arising from dermatofibrosarcoma protuberans (100%) nil  100
anonymous Sarcoma arising in dermatofibrosarcoma protuberans. nil  95
anonymous Fibrosarcoma arising from dermatofibrosarcoma protruberens. nil  95
anonymous Dermatofibrosarcoma protuberans with focal fibrosarcomatous transformation, 100%. Confirm by immunohistochemical studies (CD34 positive, Cytokeratin negative)  100
anonymous Dermatofibrosarcoma protuberans with fibrosarcoma 100%. CD34+ for DFSP areas. Remote ddx: monophasic synovial sarcoma, EMA+, CK+ focally. Sampling to look for epithelial element of synovial sarcoma.  100
anonymous Malignant spindle cell tumor, suggestive of fibrosarcoma arising from dermatofibrosarcoma protuberans.(100%) Do CD34 stain to highlight the DFSP area.  100
anonymous Thigh SOFT TISSUE tumor - DERMATOFIBROSARCOMA PROTUBERANS 100% nil  90
anonymous Sarcoma ddx: Monophasic synovial sarcoma (70%), dermatofibrosarcoma protuberans (20%), fibrosarcoma (10%) immunostain: cytokeratin, EMA, CD34 more sampling to look for glandular component  60
anonymous Hige grade sarcoma 100% DDX: monophasic synovial sarcoma, fibrosarcoma Suggest immunohistochemical study i.e. EMA, cytokeratin, CD99 for further classification  50
anonymous Fibrosarcoma arising from Dermatofibrosarcoma protruberans nil  95
anonymous Dermatofibrosarcoma Protuberans nil  90
anonymous Dermatofibrosarcoma protuberans with fibrosarcomatous change nil  100
anonymous DDx: dermatofibrosarcoma protuberans with fibrosarcoma area Synovial sarcoma. Perform CD34 (positive in DFSP) and CEA, EMA, CD99 (positive in synovial sarcoma). Probability: 100% nil  90
anonymous Dermatofibrosarcoma protuberans with fibrosarcomatous pattern. 100%. CD34 stain  100
anonymous Dermatofibrosarcoma protuberans with focal fibrosarcomatous area (100%) nil  100