Imaging of the tumor as described above is a critical part of the staging process. cheap viagra Additionally, since the lungs are the most common site of metastasis, radiography and ct scanning of the chest is routinely undertaken. With liposarcoma, ct of the abdomen is also recommended due to the relatively common involvement of retroperitoneal and visceral spaces. Laboratory studies including cbc, sedimentation rate and chemistries should be obtained. These tests provide insight into the systemic response elicited by the tumor, and provide a baseline by which therapy may be monitored. Biopsy is critical, as it is the means by which tissue is acquired in order to make a definitive diagnosis. viagra vs. viagra side effects The histology (or the way it looks under the microscope) of the tumor gives the first clues to its behavior. The requisite tissue can be obtained via needle aspiration or through open incisional or excisional biopsy methods. where to buy viagra in perth w.a Open techniques constitute surgery and are performed in the operating room. buy viagra canada These provide the most tissue for review by the pathologist, however are often not necessary, or even appropriate. Because many soft tissue sarcomas are readily palpable, needle biopsy is often all that is necessary. This is frequently performed by a radiologist under ct guidance. buy viagra Incisional biopsy sometimes is necessary to attain an adequate sample of tissue. generic viagra canada price This involves making an incision in the skin, and obtaining some pieces of the tumor for evaluation. Except for the rarest of instances, excisional biopsy (removing the entire tumor as a biopsy) should be avoided with suspected sarcomas as a well-planned, definitive resection after appropriate staging and tissue diagnosis is preferred. Figure 3: surgical & pathological... Liposarcoma pathology once tissue from a biopsy or resection is obtained, it is examined under the microscope to determine its histology. There are many special kinds of tests that may be run to aid the pathologist in making a diagnosis from the provided specimen. For this reason, biopsy results may take several days or sometimes even weeks to be finalized. Figure 4a-b: surgical & pathological... best generic viagra in india The world health organization currently recognizes four subtypes of liposarcoma: well-differentiated (or atypical lipoma), myxoid, pleomorphic and dedifferentiated (christopher 2002). zoloft viagra side effects While these categories represent various points on a spectrum of disease, each of these entities displays its own unique character. viagra cost Table i provides a simplified description of each of the aforementioned subtypes. Also, see figure 3 and figure 4. Table i: liposarcoma subtypesâ  well-differentiated includes atypical lipomaâ  most common subtype (50% of liposarcomas)â  low grade (doesn’t metastasize, but may recur locally)â  risk of dedifferentiation myxoid intermediate gradeâ  includes round-cell variant as its high-grade counterpartâ  most common type in pedia. buy viagra cheap
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