Proliferative Fasciitis & Myositis...Explained by a Soft Tissue Pathologist

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Proliferative fasciitis and proliferative myositis can look scary! These are benign reactive lesions of soft tissue, but they can easily get confused with sarcoma because of their huge weird ganglion-like cells and their abundant mitoses. I still struggle with these cases in practice sometimes, even as a fellowship-trained soft tissue pathologist. Hopefully, some of my diagnostic tips and tricks will help you better understand these challenging entities. If you haven't yet seen my video on nodular fasciitis, you may find it useful as it pairs well with this topic: kikoxp.com/posts/3618
Special thanks to my dermatopathology fellow, Dr. Ed Fulton, for selecting these slides and helping with the production of this video.
This video is geared toward 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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[@JMGardnerMD]

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

[@dr.tintinthein8566]

We can feel that you have kind heart, you want us to be able to understand clearly. Thank you profoundly, Prof.

[@shamsdarbar6492]

Thank you very much for your service. Explanation is great , Quality of the slides are great. The most important thing is you really know that what do I want. You know what do I need as pathology student. I know you have lots of other things to do and you are busy, but we need you and want you to post more videos. I do not have the luxury to have teacher like you or decent teaching material. I think your videos are the only thing which can compensate. The words that I have written here do not come from head it comes from my heart. Please be VERY CLEAR that we truly appreciate every single effort that you put to teach medicine to people who live on the other side of the globe and it is more valuable than you think. THANK YOU VERY MUCH LOTS OF RESPECT.

[@JMGardnerMD]

Thank you! This means so much to me. I will make more videos.

[@shamsdarbar6492]

Thank you again.

[@rabiataseer8369]

Bless you, beautifully explained

[@kathrinemariesteffensen8528]

So nice.. Love it.

[@Aashi429]

Thank you dr.jerad

[@LOLsaudi]

you make studying enjoyable.

[@ericaayomo]

Great video. Thanks a lot!!

[@torresnicolas8599]

Thank you very much, great video!

[@loudefeo2510]

Thank You

[@maryamabdulmajed5525]

Thank you

[@junudevi8065]

Thank you , very informative video 👍

[@ncorry8491]

You have a real craft for describing the morphological features. I was wondering if you could perhaps show us examples of your pathological reports for various entities. It would be great to see how you put it all together and convey the information to the clinicians. Maybe you could copy examples of reports into the video descriptions.

[@JMGardnerMD]

That’s on my to do list

[@znrsmsaa3655]

Amazing 🤩

[@AA-ps4ze]

Great video, Thank You! I wonder if the gene fusion MYH9-USP6 was also detected in Proliferative Fasciitis and Myositits? Or only in Nodular Fasciitis? I'm searching for the article about that (I'm preparing for the pathology exam...) but I can't find that information.

[@LOLsaudi]

was wondering that too :D

[@zeenatpatavegar2411]

Plz show Vidio of MPC- myopericytoma

[@JMGardnerMD]

Here’s a video about myopericytoma: kikoxp.com/posts/2994

[@aurelioschug801]

After an injury in my Hand (muscle) a tumor started growing in the same place. I had 3 different diagnosis: first they told me Leiomyosarcoma G1. A couple of weeks later they told me Leiomyosarcoma G3 and now they told it is a Rhabdomyosarcoma. Now I have to decide if I accept chemotherapy or not... This decision is not easy for me because I ask myself if I really have Rhabdomyosarcoma... Any opinions?

[@JMGardnerMD]

I’m sorry to hear this. Have you had your pathology specimen sent to a soft tissue pathology expert for second opinion? That might be helpful in confirming the diagnosis. Sharon Weiss at Emory University in Atlanta (my mentor) or Christopher Fletcher at Brigham and Women’s in Boston are both world experts. There are other experts around the world too. Where do you live?

[@aurelioschug801]

@@JMGardnerMD Thanks so much for your suggestions!! I just came back home from the University Clinic of Heidelberg (in Germany) (were I am receiving my treatment) . Today I received the great news that no metastases were found in the CT scan I did last week. It has been more than 6 months since I first went to the doctor because of this tumor. All the different diagnoses came from same institution (University Clinic of Heidelberg), that is why I decided to follow your advice and ask a soft tissie pathology expert (Prof Eva Wardelmann from the University Clinic of Münster) for a second opinion. The tumor was fully removed and after that I received 6 weeks of radiation therapy (thinking that it was a Leiomyosarcoma). Now my oncologist wants me to start a chemotherapy as soon as possible (after the diagnoses changed to Rhabdomyosarcoma)... but I told him that I will not do it as long as I am not shore what kind of tumor it was. I want to avoid over medication and/or wrong medication. I am 32 years old. Thanks allot!

[@JMGardnerMD]

Please let me know what the expert thinks. There are several different types of rhabdomyosarcoma and each is different from the other. Rhabdomyosarcomas usually happen in kids but I have seen them occasionally in adults too. Best wishes for health to you in 2019 and beyond!

[@MaDe-hl8lb]

Does a size of 13 cm with morphology of proliferative fasciitis exclude the diagnosis ..mitosis are a bit frequent ,but no atypical forms ..many thanks

[@JMGardnerMD]

That size would make me very nervous.

[@MaDe-hl8lb]

@@JMGardnerMD ..then I guess I should be too ..🙂