2013软组织与骨肿瘤分类第4版

1、WHO classification of tumours of soft tissue TNM classification of soft tissue sarcomas1 Tumours of soft tissue: Introduction Epidemiology EtiologyClinical featuresImaging of tumours of soft tissue Grading and staging of sarcomas2 Adipocytic tumoursLipoma Lipomatosis Lipomatosis of nerve Lipoblastom

2、a Angiolipoma Myolipoma of soft tissueChondroid lipoma Spindle cell/pleomorphic lipomaHibernomaAtypical lipomatous tumourDedifferentiated liposarcoma Myxoid liposarcoma Pleomorphic liposarcoma3 Fibroblastic/myofibroblastic tumoursNodular fasciitisProliferative fasciitis and proliferative myositisMyo

3、sitis ossificans and fibro-osseous pseudotumour of digits Ischaemic fasciitis ElastofibromaFibrous hamartoma of infancy Fibromatosis colli Juvenile hyaline fibromatosisInclusion body fibromatosisFibroma of tendon sheathDesmoplastic fibroblastomaMammary-type myofibroblastoma Calcifying aponeurotic fi

4、bromaAngiomyofibroblastoma Cellular angiofibromaNuchal-type fibroma Gardner fibromaCalcifying fibrous tumourPalmar/plantar fibromatosisDesmoid-type fibromatosisLipofibromatosisGiant cell fibroblastoma Dermatofibrosarcoma protuberans Extrapleural solitary fibrous tumourInflammatory myofibroblastic tu

5、mourLow-grade myofibroblastic sarcomaMyxoinflammatory fibroblastic sarcoma Infantile fibrosarcoma Adult fibrosarcoma Myxofibrosarcoma Low-grade fibromyxoid sarcoma Sclerosing epithelioid fibrosarcoma 4 So-called fibrohistiocytic tumoursTenosynovial giant cell tumour, localized type Tenosynovial gian

6、t cell tumour, diffuse type Deep benign fibrous histiocytoma Plexiform fibrohistiocytic tumour Giant cell tumour of soft tissue5 Smooth-muscle tumoursLeiomyoma of deep soft tissueLeiomyosarcoma 6 Pericytic (perivascular) tumoursGlomus tumoursMyopericytoma, including myofibromaAngioleiomyoma7 Skeleta

7、l-muscle tumoursRhabdomyomaEmbryonal rhabdomyosarcoma Alveolar rhabdomyosarcomaPleomorphic rhabdomyosarcoma Spindle cell/sclerosing rhabdomyosarcoma 8 Vascular tumoursHaemangiomasEpithelioid haemangiomaAngiomatosisLymphangioma Kaposiform haemangioendothelioma Retiform haemangioendothelioma Papillary

8、 intralymphatic angioendothelioma Composite haemangioendothelioma Kaposi sarcoma Pseudomyogenic haemangioendothelioma Other intermediate vascular neoplasmsEpithelioid haemangioendotheliomaAngiosarcoma of soft tissue9 Chondro-osseous tumoursSoft-tissue chondromaExtraskeletal osteosarcoma 10 Gastroint

9、estinal stromal tumours11 Nerve sheath tumoursSchwannoma (including variants)Melanotic schwannomaNeurofibroma (including variants)PerineuriomaGranular cell tumour Dermal nerve sheath myxoma Solitary circumscribed neuroma Ectopic meningioma/meningothelial hamartomaNasal glial heterotopia Benign Trito

10、n tumour Hybrid nerve sheath tumoursMalignant peripheral nerve sheath tumourMalignant granular cell tumourEctomesenchymoma12 Tumours of uncertain differentiationAcral fibromyxomaIntramuscular myxomaJuxta-articular myxomaDeep (aggressive) angiomyxomaPleomorphic hyalinizing angiectatic tumour of soft

11、partsEctopic hamartomatous thymomaAtypical fibroxanthomaAngiomatoid fibrous histiocytomaOssifying fibromyxoid tumourMyoepithelioma/myoepithelial carcinoma/mixed tumourHaemosiderotic fibrolipomatous tumourPhosphaturic mesenchymal tumourSynovial sarcoma Epithelioid sarcoma Alveolar soft part sarcomaCl

12、ear cell sarcoma of soft tissueExtraskeletal myxoid chondrosarcoma Malignant mesenchymomaDesmoplastic small round cell tumourExtrarenal rhabdoid tumourPEComaIntimal sarcoma 13 Undifferentiated/unclassified sarcomasWHO classification of tumours of boneTNM classification of bone sarcomas 14 Tumours of

13、 bone: Introduction 15 Chondrogenic tumoursOsteochondromaChondromas: enchondroma, periosteal chondromaChondromyxoid fibromaOsteochondromyxomaSubungual exostosis and bizarre parostealosteochondromatous proliferationSynovial chondromatosisChondroblastomaChondrosarcoma (grades I-III) including primary

14、and secondary variants and periosteal chondrosarcomaDedifferentiated chondrosarcomaMesenchymal chondrosarcomaClear cell chondrosarcoma16 Osteogenic tumoursOsteomaOsteoid osteomaOsteoblastomaLow-grade central osteosarcomaConventional osteosarcomaTelangiectatic osteosarcomaSmall cell osteosarcomaParos

15、teal osteosarcomaPeriosteal osteosarcomaHigh-grade surface osteosarcoma17 Fibrogenic tumoursDesmoplastic fibroma of boneFibrosarcoma of bone 18 Fibrohistiocytic tumoursNon-ossifying fibroma and benign fibrous histiocytoma of bone 19 Ewing sarcoma 20 Haematopoietic neoplasms Plasma cell myelomaSolita

16、ry plasmacytoma of bone Primary non-Hodgkin lymphoma of bone21 Osteoclastic giant cell-rich tumoursGiant cell lesion of the small bones Giant cell tumour of bone 22 Notochordal tumoursBenign notochordal cell tumourChordoma 23 Vascular tumoursHaemangiomaEpithelioid haemangiomaEpithelioid haemangioend

17、otheliomaAngiosarcoma 24 Myogenic, lipogenic and epithelial tumoursLeiomyosarcoma Lipoma Liposarcoma Adamantinoma25 Tumours of undefined neoplastic nature Aneurysmal bone cyst Simple bone cystFibrous dysplasia Osteofibrous dysplasia Langerhans cell histiocytosis Erdheim-Chester disease Chondromesenc

18、hymal hamartomaRosai-Dorfman disease26 Undifferentiated high-grade pleomorphic sarcoma27 Tumour syndromesIntroductionBeckwith-Wiedemann syndromeCherubismEnchondromatosis: Ollier disease and Maffucci syndromeLi-Fraumeni syndromeMcCune-Albright syndromeMultiple osteochondromasNeurofibromatosis type 1R

19、etinoblastoma syndromeRothmund-Thomson syndromeWerner syndrome软组织肿瘤的分类软组织肉瘤的TNM分类软组织肿瘤1例：介绍流行病学病因临床特点软组织肿瘤的影像学分级和分期的肉瘤2脂肪细胞肿瘤脂肪瘤脂肪瘤病神经脂肪瘤病脂肪母细胞瘤血管脂肪瘤软组织平滑肌脂肪瘤软骨样脂肪瘤梭形细胞/多形性脂肪瘤蛰伏脂瘤非典型性肿瘤去分化脂肪肉瘤黏液样脂肪肉瘤多形性脂肪肉瘤3纤维母细胞/肌纤维母细胞瘤结节性筋膜炎增生性筋膜炎、增生性肌炎骨化性肌炎和纤维骨性假瘤数字缺血性筋膜炎弹力纤维瘤婴儿纤维性错构瘤颈部纤维瘤病幼年性透明纤维瘤病包涵体病腱鞘纤维瘤DF乳腺型

20、肌纤维母细胞瘤钙化性腱膜纤维瘤血管肌纤维母细胞瘤细胞性血管纤维瘤颈型纤维瘤加德纳纤维瘤钙化性纤维性肿瘤手掌/足底纤维瘤病韧带样纤维瘤病lipofibromatosis巨细胞纤维母细胞瘤隆突性皮肤纤维肉瘤胸膜孤立性纤维性肿瘤炎性肌纤维母细胞瘤低度恶性肌纤维母细胞肉瘤黏液炎性纤维母细胞肉瘤婴儿型纤维肉瘤成人纤维肉瘤黏液纤维肉瘤低度恶性纤维黏液肉瘤硬化性上皮样纤维肉瘤4所谓的纤维组织细胞肿瘤腱鞘巨细胞瘤，腱鞘巨细胞瘤局限型，弥漫型深丛状纤维组织细胞肿瘤良性纤维组织细胞瘤巨细胞瘤软组织5平滑肌肿瘤深部软组织平滑肌瘤平滑肌肉瘤6周（周）肿瘤血管球瘤肌周细胞瘤，包括肌纤维瘤血管平滑肌瘤7骨骼肌肿瘤横纹肌瘤

21、胚胎性横纹肌肉瘤腺泡状横纹肌肉瘤多形性横纹肌肉瘤梭形细胞/硬化性横纹肌肉瘤8血管肿瘤血管瘤上皮样血管瘤血管瘤病淋巴管瘤卡波西样血管内皮瘤网状血管内皮瘤乳头状淋巴管瘤复合血管内皮瘤卡波济肉瘤pseudomyogenic血管内皮瘤其他中间血管肿瘤上皮样血管内皮瘤软组织肉瘤9骨软骨瘤软组织软骨瘤骨外骨肉瘤10胃肠道间质瘤11神经鞘瘤神经鞘瘤（包括变种）黑色素性神经鞘瘤神经纤维瘤（包括变种）神经束膜瘤颗粒细胞瘤皮肤神经鞘粘液瘤孤切神经瘤异位脑膜瘤/上皮错构瘤鼻神经胶质异位良性肿瘤的Triton混合神经鞘肿瘤恶性外周神经鞘瘤恶性颗粒细胞瘤ectomesenchymoma12肿瘤的不确定分化肢端纤维黏液瘤肌内黏液瘤关节旁粘液瘤深（“侵略”）性多形性透明变性血管扩张性肿瘤软组织异位性错构瘤性胸腺瘤非典型纤维黄色瘤血管瘤样纤维组织细胞瘤骨化性纤维黏液瘤肌上皮瘤/肌上皮癌/混合瘤haemosiderotic fibrolipomatous肿瘤间质瘤phosphaturic滑