CHAPTER 6 TUMORS AND TUMOR-LIKE LESIONS
PEDIATRIC ‘BLASTOMAS’ / ‘SMALL ROUND CELL’ TUMORS
INTRODUCTION
HANDLING OF PEDIATRIC TUMOR SPECIMENS
Issues specific to needle core biopsy specimen interpretation in pediatric tumor diagnosis (Figs 6.1, 6.2)


Fig 6.1 Low power scan of a glass slide with tumor core biopsies demonstrating multiple cores of tissue for diagnosis.
PERIPHERAL NEUROBLASTIC TUMORS (NTS)
NEUROBLASTOMA
Histopathological features (Figs 6.3–6.8)

Figs 6.3–6.4 Macroscopic photographs of adrenal-associated neuroblastomas, demonstrating variable appearance from expansion of the adrenal cortex by dark tumor to nodular architecture of soft, cream-brown viable tumor.

Figs 6.5–6.8 Photomicrographs of cases of neuroblastoma, demonstrating tumor composed of sheets and nests of small ovoid cells within a variably prominent neurofibrillary background.
GANGLIONEUROBLASTOMA, INTERMIXED (Figs 6.11–6.14)

Figs 6.11–6.12 Macroscopic photographs of ganglioneuroblastoma, intermixed, demonstrating solid expansile masses with yellow cut surface. Note the area of hemorrhage in Fig 6.12 compared to the area of neuroblastomatous tissue in ganglioneuroblastoma, nodular in Fig 6.15.
GANGLIONEUROBLASTOMA, NODULAR (Figs 6.15–6.17)

Fig 6.15 Macroscopic photograph of a ganglioneuroblastoma, nodular demonstrating a uniform, bland solid yellow lesion with a macroscopically visible area of hemorrhagic neuroblastoma.
GANGLIONEUROMA (Figs 6.18–6.20)
NEUROBLASTOMA (SCHWANNIAN STROMA POOR), NOS
Additional investigations
Pitfalls and specific issues


Fig 6.24 Macroscopic photograph of a post-chemotherapy neuroblastoma, demonstrating areas of hemorrhage, necrosis and dystrophic calcification.
EMBRYONAL RHABDOMYOSARCOMA
Histopathological features (Figs 6.26–6.31)

Figs 6.26–6.27 Macroscopic photographs of bladder and soft-tissue rhabdomyosarcomas, demonstrating poorly circumscribed, infiltrating lesions of viable cream-colored tumor.

Figs 6.28–6.31 Photomicrographs of embryonal rhabdomyosarcomas, demonstrating ovoid to spindled tumor cells in a loose background stroma, with patchy and variable cytoplasmic eosinophilic rhabdomyomatous differentiation. The cellularity is often variable but is usually most marked immediately beneath the epithelial layer.
Differential diagnosis and pitfalls
ALVEOLAR RHABDOMYOSARCOMA
Differential diagnoses and pitfalls
EXTRASKELETAL MYXOID CHONDROSARCOMA
Histopathological features

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