Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Pathology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Eur J Radiol. 2021 Oct;143:109937. doi: 10.1016/j.ejrad.2021.109937. Epub 2021 Aug 28.
The WHO classification of soft tissue tumours categorizes the lesions based on histological differentiation. In the recent fifth edition (2020), many new entities have been introduced, based on their distinct biological behaviour, genetics and morphology. With the recent advances and better understanding of molecular genetics, several novel recurrent genetic alterations have been incorporated in this edition. These may serve as reliable diagnostic and prognostic markers for various soft tissue tumours. Though predominantly a pathologist's game; the radiologists must be aware of the recent updates to contribute towards the optimal diagnosis and management of soft tissue tumours. The imaging features of the new entities have not yet been described but are expected to be explored in the coming years. We hereby present a concise review of the updates in the recent WHO classification of soft tissue tumours. We have tried to emphasize the novel molecular genetics and their surrogate immunohistochemical markers which have brought a paradigm shift in the diagnosis, therapeutics, and prognosis of soft tissue tumours. We also present simplified diagnostic algorithms to characterize soft tissue tumours based on the clinico-radiological features.
世界卫生组织(WHO)软组织肿瘤分类基于组织学分化对病变进行分类。在最近的第五版(2020 年)中,根据其独特的生物学行为、遗传学和形态学,引入了许多新实体。随着分子遗传学的最新进展和更好的理解,在这一版中纳入了几种新的复发性遗传改变。这些可能成为各种软组织肿瘤的可靠诊断和预后标志物。尽管主要是病理学家的工作;放射科医生必须了解最新的更新,以有助于软组织肿瘤的最佳诊断和管理。新实体的影像学特征尚未描述,但预计在未来几年内将进行探索。我们在此简要介绍了最近 WHO 软组织肿瘤分类的更新。我们试图强调新的分子遗传学及其替代免疫组织化学标志物,这些标志物在软组织肿瘤的诊断、治疗和预后方面带来了范式转变。我们还根据临床放射学特征提出了简化的诊断算法来描述软组织肿瘤。