Soft Tissue Pathology (epithelioid fibrous histiocytoma ALK-1, atypical FH, paraganglioma, and more)

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07/08/23

Soft tissue pathology cases with my pathology resident, Dr. Fatima Absar! Enjoy.

Topics discussed (click timestamp to jump to that part of the video):

Epithelioid fibrous histiocytoma (EFH) (aka Epithelioid cell histiocytoma) 0:00
Dermatofibroma (lipidized "ankle-type") plus tattoo 13:40
Atypical fibrous histiocytoma (atypical dermatofibroma): 18:59
Traumatic neuroma (and nerve histology discussion) 28:48
Nerve vs Smooth Muscle Histology 34:55
Solitary bone cyst aka unicameral bone cyst (UBC) aka simple bone cyst 38:04
Schwannoma with ancient change 46:18
Lipoma arborescens (synovial lipomatosis) 58:08
Synovial chondromatosis 1:02:20
Paraganglioma of carotid body 1:07:43

***sample pathology report template links coming soon
***WSI digital slide links coming soon

Other useful videos and links:

The salt on silk effect that makes a cartilage-type look: https://youtu.be/M5dU-WuJLj8
Tendon vs Nerve Histology Made Simple with the Ramen Noodle Sign (of Fulton) video: https://kikoxp.com/posts/4466
AFX video: https://kikoxp.com/posts/4238
ABC video: https://kikoxp.com/posts/4514
Schwannoma 101 video https://kikoxp.com/posts/4093
Neurofibroma 101 video: https://kikoxp.com/posts/4091
MPNST video https://kikoxp.com/posts/4092
Alveolar soft part sarcoma (vs alveolar rhabdomyosarcoma) video: https://kikoxp.com/posts/4580

Kaddu, Steven, et al. “Atypical Fibrous Histiocytoma of the Skin: Clinicopathologic Analysis of 59 Cases with Evidence of Infrequent Metastasis.” The American Journal of Surgical Pathology, vol. 26, no. 1, Jan. 2002, pp. 35–46. PubMed, https://doi.org/10.1097/00000478-200201000-00004. https://pubmed.ncbi.nlm.nih.gov/11756767/

Publications about EFH:

I was wrong. Jedrych et al was actually the first to report ALK in epithelioid fibrous hstiocytoma. Doyle et al followed this up with a larger study soon after.

Jedrych, J., et al. “Epithelioid Cell Histiocytoma of the Skin with Clonal ALK Gene Rearrangement Resulting in VCL-ALK and SQSTM1-ALK Gene Fusions.” The British Journal of Dermatology, vol. 172, no. 5, 2015, pp. 1427–29. PubMed, https://doi.org/10.1111/bjd.13548. https://pubmed.ncbi.nlm.nih.gov/25413595/

Doyle, Leona A., et al. “ALK Rearrangement and Overexpression in Epithelioid Fibrous Histiocytoma.” Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc, vol. 28, no. 7, July 2015, pp. 904–12. PubMed, https://doi.org/10.1038/modpathol.2015.49. https://pubmed.ncbi.nlm.nih.gov/25857825/

Martinez, Anthony P., et al. “‘Chondroblastoma-like’ Epithelioid Fibrous Histiocytoma: A Previously Undescribed and Potentially Confusing Variant.” Journal of Cutaneous Pathology, vol. 45, no. 2, Feb. 2018, pp. 99–103. PubMed, https://doi.org/10.1111/cup.13068. https://pubmed.ncbi.nlm.nih.gov/29068085/

Here's our paper about dot-like ALK in EFH:
Dawson, Kellen, et al. “Epithelioid Fibrous Histiocytoma With Dot-Like Perinuclear ALK Expression and PRKAR2A-ALK Fusion.” The American Journal of Dermatopathology, vol. 42, no. 11, Nov. 2020, pp. 861–64. PubMed, https://doi.org/10.1097/DAD.0000000000001666. https://pubmed.ncbi.nlm.nih.gov/32379091/

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: https://kikoxp.com/posts/5084 (dermpath) & https://kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: http://bit.ly/2Te2haB ‬

This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.

Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.

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