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Chap 34 - MISCELLANEOUS TUMOR-LIKE LESIONS, AND HISTIOCYTIC AND FOREIGN BODY REACTIONS

Published online by Cambridge University Press:  01 March 2011

By
Markku Miettinen
Edited by
Markku Miettinen
Markku Miettinen
Affiliation:
Armed Forces Institute of Pathology, Washington DC
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Summary

This chapter includes a variety of non-neoplastic lesions that can form tumor-like masses or histologically simulate a neoplasm. Among these are histiocytic reactions to apparently noninfectious stimuli (e.g., granuloma annulare, pulse granuloma) and infections (e.g., mycobaterial pseudotumor, malakoplakia, and xanthogranulomatous reaction to infection). Accumulation or retention of foreign material can cause tumor-like reactive masses (e.g., retained cotton sponge), or microscopically can simulate a tumor, such as mucinous or signet ring cell carcinoma or chordoma (polyvinylpyrrolidone storage in histiocytes). Another example of permanently retained diagnostically used material is thorotrast, a historically used radioactive contrast medium associated with fibrous tumors at injection sites and hepatic malignancies. In the case of gadolinium-associated fibrosis, the fibrous reaction is visible, whereas the causative agent is not microscopically detectable. Finally, amyloid tumor is discussed here, including its variants associated with systemic amyloidosis and lymphoplasmacytic lymphoma (immunoglobulin light-chain–derived amyloidosis).

ORGANIZING HEMATOMA

Soft tissue hematoma can form a long-standing and expanding tumor-like mass that clinically, radiologically, and even pathologically sometimes simulates a neoplasm. Such lesions have been variably referred to as post-traumatic cyst of soft tissue, chronic expanding hematoma, and ancient hematoma. Calcified myonecrosis is a related term, with this condition also including a significant component of muscular necrosis and often developing after conditions such as compartment syndrome.

Clinical Features

Organizing hematoma can develop in a variety of soft tissue sites that most commonly include the thigh, abdominal wall, and chest wall.

Type
Chapter
Information
Modern Soft Tissue Pathology
Tumors and Non-Neoplastic Conditions
 , pp. 965 - 981
Publisher: Cambridge University Press
Print publication year: 2010

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References

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Mentzel, T, Goodlad, JR, Smith, MA, Fletcher, CD. Ancient hematoma: a unifying concept for a post-traumatic lesion mimicking an aggressive soft tissue neoplasm. Mod Pathol 1997;10:334–340.Google ScholarPubMed
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Kohl, SK, Hans, CP. Cutaneous malakoplakia. Arch Pathol Lab Med 2008;132:113–117.Google ScholarPubMed
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Mentzel, T, Goodlad, JR, Smith, MA, Fletcher, CD. Ancient hematoma: a unifying concept for a post-traumatic lesion mimicking an aggressive soft tissue neoplasm. Mod Pathol 1997;10:334–340.Google ScholarPubMed
O'Keefe, RJ, O'Connell, JX, Temple, HT, Scully, SP, Kattapuram, SV, Springfield, DS. Calcific myonecrosis: a late sequela to compartment syndrome of the leg. Clin Orthop 1995;318:205–213.Google Scholar
Felner, EI, Steinberg, JB, Weinberg, AG. Subcutaneous granuloma annulare: A review of 47 cases. Pediatrics 1997;100:965–967.CrossRefGoogle ScholarPubMed
Grogg, KL, Nascimento, AG. Subcutaneous granuloma annulare in childhood: Clinicopathological features in 34 cases. Pediatrics 2001;107:1–4.CrossRefGoogle Scholar
McDermott, MB, Lind, AC, Marley, EF, Dehner, LP. Deep granuloma annulare (pseudorheumatoid nodule) in children: Clinicopathologic study of 35 cases. Pediatr Dev Pathol 1998;1:300–308.CrossRefGoogle ScholarPubMed
Barzilai, A, Huszar, M, Shapiro, D, Nass, D, Trau, H. Pseudorheumatoid nodules in adults: A juxta-articular form of nodular granuloma annulare. Am J Dermatopathol 2005;27: 1–5.CrossRefGoogle ScholarPubMed
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Alguacil-Garcia, A. Necrobiotic palisading suture granuloma simulating rheumatoid nodule. Am J Surg Pathol 1993;17:920–923.CrossRefGoogle ScholarPubMed
Toto, JR, Chu, P, Yen, TS, LeBoit, PE. Granuloma annulare and human immunodeficiency virus infection. Arch Dermatol 1999;135:1341–1346.Google Scholar
Dunlap, CL, Barker, BF. Giant-cell hyaline angiopathy. Oral Surg Oral Med Oral Pathol 1977;44:587–591.CrossRefGoogle Scholar
Barker, BF, Dunlap, CL. Hyaline rings of the oral cavity: the so-called “pulse” granuloma redefined. Semin Diagn Pathol 1987;4:237–242.Google ScholarPubMed
Talacko, AA, Radden, BG. Oral pulse granuloma: clinical and histopathological features. A review of 62 cases. Int J Oral Maxillofac Surg 1988;17:343–346.CrossRefGoogle ScholarPubMed
Talacko, AA, Radden, BG. The pathogenesis of oral pulse granuloma: an animal model. J Oral Pathol 1988;17:99–105.CrossRefGoogle Scholar
Marcussen, LN, Peters, E, Carmel, D, Mickelborough, M, Robinson, C. Legume-associated residual cyst. J Oral Pathol Med 1993;22:141–144.CrossRefGoogle ScholarPubMed
Martin, RW, Lumadue, JA, Corio, RL, Kalb, RL, Hood, AF. Cutaneous giant cell hyaline angiopathy. J Cutan Pathol 1993;20:356–358.CrossRefGoogle Scholar
Pereira, TC, Prichard, JW, Khalid, M, Medich, DS, Silverman, JF. Rectal pulse granuloma. Arch Pathol Lab Med 2001;125:822–823.Google ScholarPubMed
Zhai, J, Maluf, HM. Peridiverticular colonic hyaline rings (pulse granuloma): report of two cases associated with perforated diverticula. Ann Diagn Pathol 2004;8:375–379.CrossRefGoogle ScholarPubMed
Wood, C, Nickoloff, BJ, Todes-Taylor, NR. Pseudotumor resulting from atypical mycobacterial infection: A “histoid” variety of Mycobacterium avium-intracellulare complex infection. Am J Clin Pathol 1985;83:524–527.CrossRefGoogle ScholarPubMed
Logani, S, Lucas, DR, Cheng, JD, Ioachim, HL, Adsay, NV. Spindle cell tumors associated with mycobacteria in lymph node of HIV-positive patients: “Kaposi sarcoma with mycobacteria” and “mycobacterial pseudotumor.” Am J Surg Pathol 1999;23:656–661.CrossRefGoogle ScholarPubMed
Chen, KT. Mycobacterial spindle cell pseudotumor of lymph nodes. Am J Surg Pathol 1992;16:276–281.CrossRefGoogle ScholarPubMed
Kontochristopoulos, DJ, Aroni, K, Panteleos, DN, Tosca, AD. Immunohistochemistry in histoid leprosy. Int J Dermatol 1995;34:777–781.CrossRefGoogle ScholarPubMed
Wolf, DA, Wu, CD, Medeiros, LJ. Mycobacterial pseudotumors of lymph node: A report of two cases diagnosed at the time of intraoperative consultation using touch imprint preparations. Arch Pathol Lab Med 1995;119:811–814.Google ScholarPubMed
Sehgal, VN, Srivastava, G, Beohar, PC. Histoid leprosy – a histopathological rappraisal. Acta Leprol 1987;5:125–131.Google Scholar
Umlas, J, Federman, M, Crawford, C, O'Hara, CJ, Fitzgibbon, JS, Modeste, A. Spindle cell pseudotumor due to Mycobacterium avium-intracellulare in patients with acquired immunodeficiency syndrome (AIDS). Positive staining of mycobacteria for cytoskeleton filaments. Am J Surg Pathol 1991;15:1181–1187.CrossRefGoogle ScholarPubMed
Damjanov, I, Katz, SM. Malakoplakia. Pathol Annu 1981;16 (Part 2):103–126.Google ScholarPubMed
Douglas-Jones, AG, Rodd, C, James, EMV, Mills, RGS. Prediagnostic malakoplakia presenting as a chronic inflammatory mass in the soft tissues of the neck. J Laryngol Otol 1992;106:173–177.CrossRefGoogle Scholar
Schmerber, S,Lantuejoul, S, Lavieille, JP, Reyt, E. Malakoplakia of the neck. Arch Otolaryngol Head Neck Surg 2003;129:1240–1242.CrossRefGoogle Scholar
Kogulan, PK, Smith, M, Seidman, J, Chang, G, Tsokos, M, Lucey, D. Malakoplakia involving the abdominal wall, urinary bladder, vagina, and vulva: case report and discussion of malakoplakia-associated bacteria. Int J Gynecol Pathol 2001;20:403–406.CrossRefGoogle ScholarPubMed
Lowitt, MH, Kariniemi, AL, Niemi, KM, Kao, GF. Cutaneous malakoplakia: a report of two cases and review of the literature. J Am Acad Dermatol 1996;34:325–332.CrossRefGoogle ScholarPubMed
Bates, AW, Dev, S, Baithun, SI. Malakoplakia and colorectal adenocarcinoma. Postgrad Med J 1997:73:171–173.CrossRefGoogle ScholarPubMed
Pillay, K, Chetty, R. Malakoplakia in association with colorectal carcinoma: a series of four cases. Pathology 2002;34:332–335.CrossRefGoogle ScholarPubMed
Yousef, GM, Naghibi, B. Malakoplakia outside the urinary tract. Arch Pathol Lab Med 2007;131:297–300.Google ScholarPubMed
Kohl, SK, Hans, CP. Cutaneous malakoplakia. Arch Pathol Lab Med 2008;132:113–117.Google ScholarPubMed
McDonald, GS. Xanthogranulomatous pyelonephritis. J Pathol 1981;133:203–213.CrossRefGoogle ScholarPubMed
Goodman, ZD, Ishak, KG. Xanthogranulomtous cholecystitis. Am J Surg Pathol 1981;5:653–659.CrossRefGoogle ScholarPubMed
Ladefoged, C, Lorentzen, M. Xanthogranulomtous cholecystitis. A clinicopathological study of 20 cases and review of the literature. APMIS 1993;101:869–875.CrossRefGoogle ScholarPubMed
Cozzutto, C, Carbone, A. The xanthogranulomatous process. Xanthogranulomatous inflammation. Pathol Res Pract 1988;183:395–402.CrossRefGoogle ScholarPubMed
Parker, F. Xanthomas and hyperlipidemias. Am J Acad Dermatol 1985;13:1–30.CrossRefGoogle ScholarPubMed
Fahey, JJ, Stark, HH, Donovan, WF, Drennan, DB. Xanthoma of the Achilles tendon. J Bone Joint Surg Am 1973;55:1197–1211.CrossRefGoogle ScholarPubMed
Bulkley, BH, Buja, M, Ferrans, VJ, Bulkley, GB, Roberts, WC. Tuberous xanthoma in homozygous type II hyperlipoproteinemia. Arch Pathol 1975;99;293–300.Google ScholarPubMed
Wessel, W, Schoog, M, Winkler, E. Polyvinylpyrrolidone (PVP), its diagnostic, therapeutic and technical application and consequences thereof. Arzneimittelforsch 1971;21:1468–1482.Google Scholar
Soumerai, S. Pseudotumors of the arm following injections of procaine polyvinylpyrrolidone: report of two cases. J Med Soc NJ 1978;75:407–408.Google ScholarPubMed
Kuo, TT, Hsueh, S. Mucicarminophilic histiocytosis. A polyvinylpyrrolidone (PVP) storage disease simulating signet ring carcinoma. Am J Surg Pathol 1984;8:419–428.CrossRefGoogle Scholar
Kuo, TT, Hu, S, Hung, CL, Chan, HL, Chang, MJW, Dunn, P. Cutaneous involvement in polyvinylpyrrolidone storage disease: A clinicopathologic study of five patients, including two patients with severe anemia. Am J Surg Pathol 1997;21:1361–1367.CrossRefGoogle ScholarPubMed
Kepes, JJ, Chen, WYK, Jim, YF. “Mucoid dissolution” of bones and multiple pathologic fractures in a patient with a past history of intravenous administration of polyvinylpyrrolidone (PVP). A case report. Bone Miner 1993;22:33–41.CrossRefGoogle Scholar
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