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Ganzert C, Popov A, Lücke E, Franke S, Jechorek D, Zenker M, Walles T, Pech M, Schreiber J. Fatal course of a benign mediastinal lipoblastoma in a 20-year-old woman. Pathol Res Pract 2022; 239:154161. [DOI: 10.1016/j.prp.2022.154161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/01/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
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Alghanmi HA, Bokhari A, Zainldeen A, Almaghrabi MY, Sadek E, Saba F. Retroperitoneal Lipoblastoma With Cord Compression in an Adult Patient: A Case Report. Cureus 2022; 14:e29292. [PMID: 36168653 PMCID: PMC9506513 DOI: 10.7759/cureus.29292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2022] [Indexed: 11/05/2022] Open
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Merzouqi B, Laachoubi M, Oukessou Y, Mahtar M. Head and neck lipoblastomas: Report of 3 cases and review of the literature. Int J Surg Case Rep 2021; 84:106050. [PMID: 34139421 PMCID: PMC8219841 DOI: 10.1016/j.ijscr.2021.106050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Lipoblastoma is a rare benign tumor arising from embryonic white fat which occurs in the early childhood. It usually arises on the extremities and considered as a rare cause of a pediatric head and neck masses. The aim of this study is to shed light on lipoblastomas as a differential diagnosis of rapidly growing soft fatty masses of children in neck and head area. PATIENTS AND METHODS A retrospective review of 3 patients with lipoblastoma, underwent Surgical resection (case 1 and 2) by cervical approach. The third patient with a facial lipoblastoma was not operated due to the high risk of facial paralysis. Review of literature, diagnostic methods and genetics of lipomatous tumors are discussed. RESULTS Complete surgical excision via a cervical approach demonstrated irregular lobules of immature fat cells separated by a loose, myxoid connective tissue. Histology analysis confirmed the diagnosis of lipoblastoma. DISCUSSION Lipoblastoma is a rare childhood tumor, even rarer in head and neck area. The pathogenesis is unknown, though it is believed to arise from altered embryogenesis of human white fat and genetic predisposition, as chromosome 8 abnormalities may be implicated in the development of lipoblastoma. The presumptive diagnosis is performed by imaging. The most important differential diagnosis of lipoblastoma is myxoid liposarcoma. The mainstay of treatment is complete non-mutilating resection of the tumor to avoid recurrence. CONCLUSION Lipoblastoma should be suspected in case of heterogeneous fatty tumor in head and neck area, and included as a differential diagnosis of cervical masses in children younger than 3 years. The mainstay of treatment is complete surgical excision with a good prognosis.
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Affiliation(s)
- Boutaina Merzouqi
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Center IBN ROCHD, Casablanca, Morocco
| | - Mohammed Laachoubi
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Center IBN ROCHD, Casablanca, Morocco.
| | - Youssef Oukessou
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Center IBN ROCHD, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco
| | - Mohammed Mahtar
- ENT Department, Face and Neck Surgery, Hospital August, 20'1953, University Hospital Center IBN ROCHD, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco
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Lipoblastomas presenting in older children and adults: analysis of 22 cases with identification of novel PLAG1 fusion partners. Mod Pathol 2021; 34:584-591. [PMID: 33097826 DOI: 10.1038/s41379-020-00696-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 12/17/2022]
Abstract
Lipoblastomas are benign neoplasms of embryonal white fat that typically present in the first 3 years of life and show a lobular arrangement of maturing adipocytes with variable degrees of myxoid change. We systematically studied the clinicopathologic and genetic features of lipoblastomas arising in older children and adults. Cases with a diagnosis of lipoblastoma or maturing lipoblastoma in patients >3 years of age were retrieved from our archives. Immunostaining for CD34 and desmin and molecular studies (FISH, RNA sequencing) were performed. Twenty-two cases (8F; 14M) were identified in patients ranging from 4 to 44 years of age (median 10 years). Sites included extremity (n = 15), head and neck (n = 4), and trunk (n = 3) with tumor sizes varying from 1.6 to 17.5 cm (median 5). Only three tumors had histologic features of "conventional" lipoblastoma. The majority of tumors (n = 14) were composed of variably sized lobules of mature adipose tissue partitioned by thin fibrous septa ("maturing"). The remaining five cases consisted predominantly of bland spindled to plump ovoid cells embedded in a fibrous stroma, with a vaguely plexiform arrangement of small myxoid and adipocytic nodules ("fibroblastic"). CD34 was diffusely positive in all cases tested (21/21), while desmin immunoreactivity was identified in 12 of 21 cases (diffuse = 7, focal = 5). PLAG1 rearrangements were identified in 13 tumors in the entire cohort (59%), including all 5 fibroblastic tumors. RNA sequencing detected eight PLAG1 fusion partners, of which two were known (CHCHD7 and COL3A1) and six were novel (SRSF3, HNRNPC, PCMTD1, YWHAZ, CTDSP2, and PPP2R2A). Twelve cases had follow-up (1-107 months; median 21 months), and no recurrences were reported. Lipoblastomas may occur in older children and adults and may be difficult to recognize due to their predominantly adipocytic or fibrous appearance. Awareness that lipoblastomas may occur in older patients, careful evaluation for foci showing more typical morphologic features, ancillary immunohistochemistry for CD34 and desmin, and molecular genetic studies to identify PLAG1 rearrangements are the keys to recognizing these tumors.
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Chiang S. Recent advances in smooth muscle tumors with PGR and PLAG1 gene fusions and myofibroblastic uterine neoplasms. Genes Chromosomes Cancer 2020; 60:138-146. [PMID: 33230916 DOI: 10.1002/gcc.22920] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022] Open
Abstract
Uterine epithelioid and myxoid leiomyosarcomas and inflammatory myofibroblastic tumors are rare mesenchymal neoplasms. Next-generation sequencing recently detected novel PGR fusions in uterine epithelioid leiomyosarcomas that demonstrate characteristic rhabdoid and spindled morphology. PLAG1 gene fusions have also been identified in a subset of myxoid leiomyosarcomas and are associated with PLAG1 overexpression. ALK rearrangements underpin the vast majority of uterine inflammatory myofibroblastic tumors, which demonstrate morphologic, and immunohistochemical features similar to those of inflammatory myofibroblastic tumors elsewhere. This review summarizes the morphologic, immunophenotypic, and molecular genetic features of PGR fusion-positive epithelioid leiomyosarcoma, PLAG1 fusion-positive myxoid leiomyosarcoma, and inflammatory myofibroblastic tumors of the uterus.
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Affiliation(s)
- Sarah Chiang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Novel PLAG1 Gene Rearrangement Distinguishes a Subset of Uterine Myxoid Leiomyosarcoma From Other Uterine Myxoid Mesenchymal Tumors. Am J Surg Pathol 2020; 43:382-388. [PMID: 30489320 DOI: 10.1097/pas.0000000000001196] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Genetic alterations in uterine myxoid leiomyosarcoma are unknown. We investigate the clinicopathologic features of 19 uterine tumors previously diagnosed as myxoid leiomyosarcomas in which tumoral RNA was subjected to targeted RNA sequencing. PLAG1, BCOR, BCORL1, HMGA2, and ALK break-apart fluorescence in situ hybridization (FISH) and BCOR, PLAG1, and ALK immunohistochemistry were performed in cases which failed or lacked fusions by sequencing. The diagnosis of myxoid leiomyosarcoma was confirmed in 15 cases after exclusion of 4 tumors with BCOR and ALK rearrangements. These 15 patients presented at a median age of 50 years with stage I (3), II (2), III (2), and IV (1) tumors, respectively; stage was unknown in 7 cases. Tumor size ranged from 10 to 24 cm. Matrix was myxoid in all tumors and also eosinophilic in 2. Cells were spindled, epithelioid, and both in 10, 2, and 3 tumors and showed mild, moderate, and severe nuclear atypia in 3, 8, and 4 tumors, respectively. Mitotic index ranged from <1 to 14/10 HPF, while tumor necrosis was present in 6 (40%). Novel TRPS1-PLAG1 or RAD51B-PLAG1 fusions were detected by sequencing in 4 tumors, 3 of which were also confirmed by FISH. Diffuse PLAG1 expression was seen in 7 tumors, including 4 with PLAG1 rearrangement. No morphologic differences were seen among PLAG1 fusion-positive and fusion-negative tumors. No PLAG1, HMGA2, ALK, BCOR, or BCORL1 rearrangements were detected by FISH in 11 tumors. On the basis of sequencing and FISH results, PLAG1 rearrangements resulting in PLAG1 expression underpin ~25% of myxoid leiomyosarcomas and may serve as a useful diagnostic biomarker. Immunohistochemistry, targeted RNA sequencing, and/or FISH may distinguish myxoid leiomyosarcoma from its morphologic mimics.
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7
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Özşen M, Yalçınkaya U, Yazıcı Z, Sarısözen MB. Lipomatous Tumors in Pediatric Patients: A Retrospective Analysis of 50 cases. Turk Patoloji Derg 2020; 36:1-10. [PMID: 31282548 PMCID: PMC10512668 DOI: 10.5146/tjpath.2019.01464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/01/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although lipomatous tumors are the most common type of mesenchymal tumors in adults, they account for less than 10% of all soft tissue lesions in pediatric patients. In this descriptive study, we aim to present our series of pediatric lipomatous tumors consisting of lipoma, neural fibrolipoma, lipoblastoma, atypical lipomatous tumor, myxoid liposarcoma and pleomorphic liposarcoma, and to evaluate the clinicopathological characteristics of these tumors in reference to the literature. MATERIAL AND METHOD In this study, pediatric lipomatous tumor cases diagnosed between 2002 and 2018 were screened from pathological archives and retrospectively evaluated. RESULTS A total of 50 cases were diagnosed with lipomatous tumor within the mentioned period. Of the total cases, 24 were female (48%) and 26 were male (52%), with age distribution ranging from 1 to 204 months. Histopathological examination revealed lipoma in 26 cases (52%), lipoblastoma in 19 (38%), atypical lipomatous tumor in 2 (4%), myxoid liposarcoma in 2 (4%), and pleomorphic liposarcoma in 1 case (2%). CONCLUSION Although lipomatous tumors are the most common type of mesenchymal tumors; they rarely occur in children. Since there is a limited number of studies on pediatric lipomatous tumors in the literature, there is insufficient data on the prevalence and incidence of these tumors. These tumors may slowly enlarge to greater sizes, especially those localized in deep tissues, and may cause various clinical symptoms by compressing surrounding tissues. Local recurrences may occur, even after total excision, and require close monitoring.
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Affiliation(s)
- Mine Özşen
- Department of Pathology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ulviye Yalçınkaya
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zeynep Yazıcı
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Bartu Sarısözen
- Department of Orthopedics and Traumatology, Uludag University Faculty of Medicine, Bursa, Turkey
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Pereira-Lourenço MJ, Vieira-Brito D, Peralta JP, Castelo-Branco N. Intrascrotal lipoblastoma in adulthood. BMJ Case Rep 2019; 12:12/12/e231320. [PMID: 31826903 DOI: 10.1136/bcr-2019-231320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This case report describes the case of a 37-year-old man that noticed an intrascrotal right mass with 1 month of evolution. During physical exam presented with a large mass at the inferior portion of the right testicle, clearly separated from the testicle, with a tender consistency and mobile. An ultrasound was performed that showed a solid and subcutaneous nodular lesion, extra testicular, heterogeneous, measuring 7.2 cm. Pelvic magnetic resonance imageMRI showed a lesion compatible with a lipoma. The patient was subjected to surgical excision of the lesion by scrotal access, having histology revealed a lipoblastoma (LB) of the scrotum. Histological diagnosis was obtained by microscopic characteristics (well-circumscribed fatty neoplasm) and immunohistochemistry (stains for CD34, S100 protein and PLAG1 were positive; stains for MDM2 and CDK4 were negative). LB is extremely rare after adolescence in any location, being this first described case of intrascrotal LB described in adulthood.
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Affiliation(s)
- Mário José Pereira-Lourenço
- Urology and Kidney Transplantation, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal .,Urology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Duarte Vieira-Brito
- Urology and Kidney Transplantation, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.,Urology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - João Pedro Peralta
- Urology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Noémia Castelo-Branco
- Pathology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
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Abstract
Myxoid adipocytic tumors encompass a broad heterogeneous group of benign and malignant adipocytic tumors, which are typically myxoid (e.g. myxoid liposarcoma, lipoblastoma and lipoblastoma-like tumor of the vulva) or may occasionally appear predominantly myxoid (e.g. pleomorphic liposarcoma, atypical lipomatous tumor, dedifferentiated liposarcoma, chondroid lipoma, spindle cell/pleomorphic lipoma, atypical spindle cell lipomatous tumor and atypical pleomorphic lipomatous tumor). There have been significant advances in recent years in classification and understanding the pathogenesis of adipocytic tumors, based on the correlation of histologic, immunohistochemical, and cytogenetic/molecular findings. Despite these advances, the morphologic diagnosis and accurate classification of a myxoid adipocytic tumor can be challenging due to major morphologic overlap between myxoid adipocytic and non-adipocytic tumors. This article will provide a review on the currently known morphological, immunohistochemical and molecular features of myxoid adipocytic tumors and their differential diagnosis.
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Affiliation(s)
- David Creytens
- Department of Pathology, Ghent University and Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; CRIG, Cancer Research Institute Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium.
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10
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Undifferentiated myxoid lipoblastoma with PLAG1-HAS2 fusion in an infant; morphologically mimicking primitive myxoid mesenchymal tumor of infancy (PMMTI)--diagnostic importance of cytogenetic and molecular testing and literature review. Cancer Genet 2015; 209:21-9. [PMID: 26701195 DOI: 10.1016/j.cancergen.2015.11.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/10/2015] [Accepted: 11/12/2015] [Indexed: 02/07/2023]
Abstract
Lipoblastoma is a benign myxoid neoplasm arising in young children that typically demonstrates adipose differentiation. It is often morphologically indistinguishable from primitive myxoid mesenchymal tumor of infancy (PMMTI), which is characterized by a well-circumscribed myxoid mass with a proliferation of primitive mesenchymal cells with mild cytologic atypia. PMMTI occurs in the first year of life and is known to have locally aggressive behavior. No specific genetic rearrangements have been reported to date. In contrast, the presence of PLAG1 (Pleomorphic Adenoma Gene 1) rearrangement is diagnostic for lipoblastoma. We hereby demonstrate the combined application of multiple approaches to tackle the diagnostic challenges of a rapidly growing neck tumor in a 3-month-old female. An incisional tumor biopsy had features of an undifferentiated, myxoid mesenchymal neoplasm mimicking PMMTI. However, tumor cells showed diffuse nuclear expression by immunohistochemical (IHC) stain. Conventional cytogenetic and fluorescence in situ hybridization (FISH) analyses as well as next generation sequencing (NGS) demonstrated evidence of PLAG1 rearrangement, confirming the diagnosis of lipoblastoma. This experience warrants that undifferentiated myxoid lipoblastoma can mimic PMMTI, and the combination of cytogenetic and molecular approaches is essential to distinguish these two myxoid neoplasms. Literature on lipoblastomas with relevant molecular and cytogenetic findings is summarized. Our case is the first lipoblastoma diagnosed with a PLAG1 fusion defined by NGS technology.
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11
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Molecular cytogenetics of pediatric adipocytic tumors. Cancer Genet 2015; 208:469-81. [DOI: 10.1016/j.cancergen.2015.06.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/16/2015] [Accepted: 06/23/2015] [Indexed: 12/20/2022]
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12
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Cappellesso R, d'Amore ESG, Dall'Igna P, Guzzardo V, Vassarotto E, Rugge M, Alaggio R. Immunohistochemical expression of p16 in lipoblastomas. Hum Pathol 2015; 47:64-9. [PMID: 26514741 DOI: 10.1016/j.humpath.2015.08.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/10/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
Abstract
Lipoblastoma (LB) is a rare benign adipocytic tumor of childhood occasionally showing histological similarities to myxoid liposarcoma (ML) or well-differentiated liposarcoma (WDL). p16 immunohistochemistry has proved to be useful in distinguishing various types of liposarcomas, in particular WDL from lipoma, with higher sensitivity and specificity than MDM2 and CDK4 immunohistochemistry. In this study, we reported the histologic features of a series of 30 LB with emphasis on the potential diagnostic pitfalls and investigated the immunohistochemical expression of p16. Moreover, p16 immunostaining was performed in 16 liposarcomas (11 WDL and 5 ML), 16 lipomas, and 16 cases of liponecrosis in order to evaluate its usefulness in the differential diagnosis of challenging lesions occurring in older children. Overall, p16 immunostaining was positive in 3 LBs and in 12 out of 16 liposarcomas (10 WDL and 2 ML), with a sensitivity of 75%, a specificity of 90%, a positive predictive value of 80%, and a negative predictive value of 87%. All lipomas were p16 negative, whereas 5 liponecroses were positive. Accounting altogether the benign lesions versus liposarcomas, p16 showed a sensitivity of 75%, a specificity of 87%, a positive predictive value of 60%, and a negative predictive value of 93%. Our data suggest that a negative p16 immunostaining may be helpful in excluding a liposarcoma when occurring in unusual clinical contexts, such as in adolescence or late recurrence. However, such finding should be interpreted with caution since also some liposarcomas lack p16 and occasional LBs are positive.
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Affiliation(s)
- Rocco Cappellesso
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua (PD), Italy, 35121
| | | | - Patrizia Dall'Igna
- Department of Woman and Child Health, Pediatric Surgery Unit, University of Padua, Padua (PD), Italy, 35128
| | - Vincenza Guzzardo
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua (PD), Italy, 35121
| | - Elisa Vassarotto
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua (PD), Italy, 35121
| | - Massimo Rugge
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua (PD), Italy, 35121
| | - Rita Alaggio
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padua, Padua (PD), Italy, 35121.
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Choi J, Bouron Dal Soglio D, Fortier A, Fetni R, Mathonnet G, Cournoyer S, Lallier M, Isler M, Beaulieu Bergeron M, Patey N. Diagnostic utility of molecular and cytogenetic analysis in lipoblastoma: a study of two cases and review of the literature. Histopathology 2014; 64:731-40. [DOI: 10.1111/his.12317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 10/24/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Jungah Choi
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
| | - Dorothée Bouron Dal Soglio
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
- Research Center of CHU Sainte Justine; Montreal QC Canada
- University of Montreal; Montreal QC Canada
| | - Amanda Fortier
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
| | - Raouf Fetni
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
| | | | | | - Michel Lallier
- Department of Surgery; CHU Sainte Justine; Montreal QC Canada
| | - Marc Isler
- Department of Surgery; CHU Sainte Justine; Montreal QC Canada
| | - Mélanie Beaulieu Bergeron
- Department of Genetics; Children's Hospital of Eastern Ontario; Ottawa ON Canada
- Department of Pathology and Laboratory Medicine; University of Ottawa; Ottawa ON Canada
| | - Natalie Patey
- Department of Pathology; CHU Sainte Justine; Montreal QC Canada
- Research Center of CHU Sainte Justine; Montreal QC Canada
- University of Montreal; Montreal QC Canada
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Fallon SC, Brandt ML, Rodriguez JR, Vasudevan SA, Lopez ME, Hicks MJ, Kim ES. Cytogenetic analysis in the diagnosis and management of lipoblastomas: results from a single institution. J Surg Res 2013; 184:341-6. [PMID: 23751806 DOI: 10.1016/j.jss.2013.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 04/18/2013] [Accepted: 05/02/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lipoblastomas are rare, benign, soft tissue tumors that occur primarily in young children. Treatment includes complete excision and surveillance for recurrence. Lipoblastomas can be indistinguishable from other benign lipomatous tumors and liposarcomas. Cytogenetic analysis can provide the definitive diagnosis in questionable cases, because benign and malignant lipomatous tumors exhibit specific nonrandom cytogenetic abnormalities. The purpose of the present study was to discuss the disease management and outcomes in a large contemporary group of patients with lipoblastoma. MATERIALS AND METHODS A retrospective chart review of patients diagnosed with lipoblastoma presenting from 2000-2011 was conducted. The data from these patients were compared with data from a previously published historical group of patients (1985-1999) from the same children's hospital. RESULTS We identified 37 patients in the contemporary cohort group and compared them with 25 patients from the historical group. The tumor involvement sites were similar. The current cohort group had a lower recurrence rate, although this might have been underestimated owing to a shorter follow-up period (median 1.4 y, range 2 wk to 11.0 y). Preoperative imaging findings led to an incorrect diagnosis in 62% of the patients. Cytogenetic analysis was used to help determine the final diagnosis in 50% of the cases. In 39% of cases, translocations involved the long arm of chromosome 8, the most common anomaly in lipoblastoma. CONCLUSIONS Lipoblastomas are rare tumors in young children that can be misclassified as other malignant or benign lipomatous tumors with markedly different outcomes and treatments. We recommend that cytogenetic analysis be routinely used for all pediatric lipomatous tumors to provide an accurate diagnosis and guide appropriate therapy and follow-up.
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Affiliation(s)
- Sara C Fallon
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA
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Bruyeer E, Lemmerling M, Poorten VV, Sciot R, Hermans R. Paediatric lipoblastoma in the head and neck: three cases and review of literature. Cancer Imaging 2012; 12:484-7. [PMID: 23114460 PMCID: PMC3485648 DOI: 10.1102/1470-7330.2012.0037] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Lipoblastoma is a rare benign tumour arising from embryonic white fat. The tumours occur primarily in infancy and early childhood and usually arise from the limbs and the trunk, but neck involvement is rare. We report three cases of head and neck lipoblastoma. In all cases, imaging showed a well-delineated, fat-containing tumour. After surgical resection, the outcome of these patients was uneventful.
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Affiliation(s)
- Eveline Bruyeer
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
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16
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Abstract
Adipose and myxoid tumors in children are an unusual and challenging group of neoplasms that have some unique aspects in contrast to these tumors in adults. Less than 10% of soft tissue neoplasms in the 1st 2 decades of life have an adipose phenotype and most are benign. The most common are various types of lipoma and lipoblastoma. Liposarcoma in young patients is rare and has a distinctive distribution of histologic subtypes, including classic myxoid liposarcoma, and unusual variants, such as pleomorphic-myxoid liposarcoma. Pathologic examination enhanced by adjunct techniques, such as immunohistochemistry and cytogenetic or molecular genetic studies, is useful for classification of difficult cases. Myxoid tumors can overlap with adipose tumors and are included in this review because of the morphologic similarities and importance of diagnostic accuracy. This article reviews the clinicopathologic features of adipose and myxoid tumors with an emphasis on the unique aspects of these neoplasms in children and adolescents and the differential diagnosis.
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Affiliation(s)
- Cheryl M Coffin
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA.
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Fritchie KJ, Goldblum JR, Tubbs RR, Sun Y, Carver P, Billings SD, Rubin BP. The expanded histologic spectrum of myxoid liposarcoma with an emphasis on newly described patterns: implications for diagnosis on small biopsy specimens. Am J Clin Pathol 2012; 137:229-39. [PMID: 22261448 DOI: 10.1309/ajcp90ynokbagcdm] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The variety of histologic patterns in myxoid liposarcoma is underappreciated. The diversity of these patterns can lead to diagnostic difficulty. We examined the morphologic spectrum of myxoid liposarcoma by cataloguing and describing different patterns identified in biopsy and resection specimens of 46 primary, recurrent, and metastatic myxoid liposarcomas. The patterns identified in the 46 cases included traditional myxoid (43 [93%]), traditional round cell (17 [37%]), pseudoacinar (24 [52%]), lipoblast-rich (13 [28%]), island (11 [24%]), lipomatous (10 [22%]), stromal hyalinization (7 [15%]), cord-like (5 [11%]), nested (3 [7%]), chondroid metaplasia (2 [4%]), and hemangiopericytoma (HPC)-like (1 [2%]). Island and nested patterns had not previously been described. The diagnosis of myxoid liposarcoma was confirmed by fluorescence in situ hybridization studies for DDIT3 (also known as CHOP) rearrangement. The morphologic spectrum of myxoid liposarcoma spans well beyond its typical appearance of spindle cells in a myxoid stroma with a prominent vascular pattern. Awareness of the variety of histologic patterns is critical to avoid misdiagnosis, especially in small biopsy specimens.
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Matsuyama A, Hisaoka M, Hashimoto H. PLAG1 expression in mesenchymal tumors: An immunohistochemical study with special emphasis on the pathogenetical distinction between soft tissue myoepithelioma and pleomorphic adenoma of the salivary gland. Pathol Int 2011; 62:1-7. [DOI: 10.1111/j.1440-1827.2011.02740.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Contributions of cytogenetics and molecular cytogenetics to the diagnosis of adipocytic tumors. J Biomed Biotechnol 2011; 2011:524067. [PMID: 21274402 PMCID: PMC3025394 DOI: 10.1155/2011/524067] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2010] [Accepted: 12/15/2010] [Indexed: 12/14/2022] Open
Abstract
Over the last 20 years, a number of tumor-specific chromosomal translocations and associated fusion genes have been identified for mesenchymal neoplasms including adipocytic tumors. The addition of molecular cytogenetic techniques, especially fluorescence in situ hybridization (FISH), has further enhanced the sensitivity and accuracy of detecting nonrandom chromosomal translocations and/or other rearrangements in adipocytic tumors. Indeed, most resent molecular cytogenetic analysis has demonstrated a translocation t(11;16)(q13;p13) that produces a C11orf95-MKL2 fusion gene in chondroid lipoma. Additionally, it is well recognized that supernumerary ring and/or giant rod chromosomes are characteristic for atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma, and amplification of 12q13–15 involving the MDM2, CDK4, and CPM genes is shown by FISH in these tumors. Moreover, myxoid/round cell liposarcoma is characterized by a translocation t(12;16)(q13;p11) that fuses the DDIT3 and FUS genes. This paper provides an overview of the role of conventional cytogenetics and molecular cytogenetics in the diagnosis of adipocytic tumors.
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Amra NK, Amr SS. Mediastinal lipoblastomatosis: report of a case with complex karyotype and review of the literature. Pediatr Dev Pathol 2009; 12:469-74. [PMID: 19192950 DOI: 10.2350/08-09-0525.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lipoblastoma or lipoblastomatosis is an uncommon fatty tumor seen in children up to the age of 5 years, with very rare exceptions above that age. It usually occurs in the extremities, but it can arise in other anatomical sites, including the head and neck area, trunk, mediastinum, mesentry, and retroperitoneum. We report a 9-month-old boy with mediastinal lipoblastomatosis showing unusually complex chromosomal aberrations. Five years following surgical excision that was incomplete as a result of the tumor's proximity to major blood vessels, the patient developed a recurrence of the tumor in the mediastinum with extension to the neck and spinal dura. We present a review of the literature related to mediastinal lipoblastoma and lipoblastomatosis and the chromosomal abnormalities of these tumors.
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Affiliation(s)
- Nasir K Amra
- Pathology Services Division, Dhahran Health Center, Dhahran, Saudi Arabia.
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Hong R, Choi DY, Do NY, Lim SC. Fine-needle aspiration cytology of a lipoblastoma: a case report. Diagn Cytopathol 2008; 36:508-11. [PMID: 18528880 DOI: 10.1002/dc.20826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A lipoblastoma is a rare benign tumor of immature white fat, and more than 90% of lipoblastomas occur before the age of 3 years. The diagnosis of a lipoblastoma is mostly dependent on a histopathological examination of a surgically excised specimen. However, an accurate preoperative diagnosis is essential for the planning of surgery, particularly for a lesion of the head and neck area. We experienced a case of a cervical lipoblastoma of a 23-month-old boy. A preoperative fine-needle aspiration biopsy showed the sample as moderately cellular and showed fragments of mature and immature adipose tissues containing a large number of capillary vessels. There were numerous lipoblast-looking cells with a multivacuolated cytoplasm, and the nuclei were small, compressed by vacuoles, and centrally located. According to the cytological findings, the lesion was diagnosed as a benign adipose tumor suggestive of a lipoblastoma. Subsequent surgical excision confirmed the diagnosis of the fine-needle aspiration biopsy. The cytologic features of lipoblastoma are not well known because of the rarity of the lesion. However, the fine-needle aspiration cytological features of a lipoblastoma are sufficiently characteristic to make a specific preoperative diagnosis.
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Affiliation(s)
- Ran Hong
- Department of Pathology, College of Medicine, Chosun University, Gwangju, Korea
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Bartuma H, Domanski HA, Von Steyern FV, Kullendorff CM, Mandahl N, Mertens F. Cytogenetic and molecular cytogenetic findings in lipoblastoma. ACTA ACUST UNITED AC 2008; 183:60-3. [DOI: 10.1016/j.cancergencyto.2008.01.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 01/21/2008] [Accepted: 01/28/2008] [Indexed: 10/22/2022]
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Abstract
A large intra-abdominal mass was discovered in a 6-month-old boy during a routine well-child examination. Imaging studies revealed a solid mass which appeared to arise from the left lobe of the liver, extending caudally and filling the entire pelvis. At the time of surgical excision, the mass was found to be unassociated with the liver, but was instead localized to the omentum. Histologic examination revealed adipocytes of varying stages of maturation arranged in a lobular architecture, consistent with a lipoblastoma. This unusual tumor is only the eighth reported omental lipoblastoma [J. Hicks, A. Dilley, D. Patel, J. Barrish, S. Zhu, M. Brandt, Lipoblastoma and lipoblastomatosis in infancy and childhood: histologic, ultrastructural, and cytogenetic features. Ultrastruct. Pathol. 25 (2001) 321-333; J. Harrer, G. Hammon, T. Wagner, M. Bolkenius, Lipoblastoma and lipoblastomatosis: a report of two cases and review of the literature. Eur. J. Pediatr. Surg. 11 (2001) 342-349; S. Weiss and J. Goldblum, Enzinger and Weiss's Soft Tissue Tumors, fourth ed., Mosby, St. Louis, MO, 2001, pp. 601-605, 670-686; S. Soin, S. Andronikou, R. Lisle, K. Platt, K. Lakhoo, Omental lipoblastoma in a child; diagnosis based in CT density measurements. J. Pediatr. Hematol. Oncol. 28(1) (2006) 57-58; A. Prando, S. Wallace, J.L. Marins, R.M. Pereira, E.R. de Oliveira, M. Alvarenga, Sonographic features of benign intraperitoneal lipomatous tumors in children-report of 4 cases. Pediatr. Radiol. 20(8) (1990) 571-574; C. Blank, E. Schoenmakers, P. Rogalla, E. Huys, A. Van Rijk, N. Drieschner, J. Bullerdiek, Intragenic breakpoint within RAD51L1 in a t(6;14)(p21.3;q24) of a pulmonary chondroid hamartoma. Cytogenet. Cell Genet. 95 (2001) 17-19; S. Ingraham, R. Lynch, S. Kathiresan, A. Buckler, A. Menon, hREC2, a RAD51-like gene, is disrupted by t(12;14)(q15;q24.1) in a uterine leiomyoma. Cancer Genet. Cytogenet. 115 (1999) 56-61]. Cytogenetics revealed a karyotype of 46,XY,t(8;14)(q13;q24). While lipoblastomas characteristically involve 8q, only one prior case has been reported with 14q24 as its fusion partner [M. He, K. Das, M. Blacksin, J. Benevenia, M. Hameed, A translocation involving the placental growth factor gene is identified in an epithelioid hemangioendothelioma. Cancer Genet. Cytogenet. 168 (2006) 150-154]. We report this unique case of an omental lipoblastoma with a focus on its unusual karyotype, as well as its differentiation from myxoid liposarcoma.
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de Saint Aubain Somerhausen N, Coindre JM, Debiec-Rychter M, Delplace J, Sciot R. Lipoblastoma in adolescents and young adults: report of six cases with FISH analysis. Histopathology 2008; 52:294-8. [DOI: 10.1111/j.1365-2559.2007.02954.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Röpke A, Kalinski T, Kluba U, von Falkenhausen U, Wieacker P, Röpke M. PLAG1 activation in lipoblastoma coinciding with low-level amplification of a derivative chromosome 8 with a deletion del(8)(q13q21.2). Cytogenet Genome Res 2007; 119:33-8. [DOI: 10.1159/000109616] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 05/24/2007] [Indexed: 11/19/2022] Open
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Spinelli C, Costanzo S, Severi E, Giannotti G, Massart F. A thoracic wall lipoblastoma in a 3-month-old infant: A case report and review of the literature. J Pediatr Hematol Oncol 2006; 28:594-600. [PMID: 17006266 DOI: 10.1097/01.mph.0000212977.13749.c3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Lipoblastoma is a rare benign tumor of adipose tissue seen almost always in infancy and early childhood. Lipoblastoma is present in 2 forms which are pathologically identical: circumscribed and diffuse. It is typically located in the extremities, and less frequently in head-neck region, trunk, and various organs. Lipoblastoma is a tumor with good prognosis with no reported metastases, despite its potential for local invasion and rapid growth. Our patient was a 3-month-old boy who was brought to our clinic for rapidly growing mass in the right hemithorax. With the aim of both diagnosis and treatment, the lipomatous mass was removed by local resection. In addition to the patient's age, histologic and cytogenetic analyses assisted the diagnosis of diffuse lipoblastoma. In the postoperative period, the thorax wall was unaffected, and after 6 years of follow-up no recurrence was observed. In the English literature, 8 cases of thoracic wall lipoblastoma have been previously reported, and only 3 of diffuse form. Here, we report, at our knowledge, the fourth case of thoracic diffuse lipoblastoma, in which cytogenetic analysis showed a previously undescribed karyotype aberration involving chromosomes 8, 13, and 16.
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Brandal P, Bjerkehagen B, Heim S. Rearrangement of chromosomal region 8q11-13 in lipomatous tumours: correlation with lipoblastoma morphology. J Pathol 2006; 208:388-94. [PMID: 16308870 DOI: 10.1002/path.1879] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cytogenetics is of considerable value when diagnosing lipomatous tumours, as different tumour types have different more or less specific chromosomal abnormalities. One such entity is lipoblastoma, which is a benign lipomatous tumour that often exhibits rearrangements of chromosome bands 8q11-13, and the gene PLAG1 has been implicated as the target of these chromosomal changes. All lipomatous tumours karyotyped at the Norwegian Radium Hospital were reviewed, looking for rearrangements of 8q11-13. Five tumours exhibiting chromosomal abnormalities affecting this region were found. Only one of them was morphologically diagnosed as a lipoblastoma, two being classified as lipomas, one as a hibernoma, and one as a well-differentiated liposarcoma. The two tumours successfully analysed with bacterial artificial chromosomes (BACs) covering the gene PLAG1 showed involvement of this gene in the rearrangement. The findings raise the question as to what extent the diagnosis lipoblastoma should be based on histopathological or cytogenetic/molecular data or a combination thereof. When karyotypic information from this series was combined with available literature data, it was found that the sensitivity of 8q11-13 rearrangements for diagnosing lipoblastomas when found in a lipomatous tumour was 77% and that the corresponding specificity was 98%. The validity of these calculations of the diagnostic information provided by the cytogenetic findings is, of course, totally dependent on the morphological diagnosis made in each case. Regardless of what the precise phenotypic diagnosis was, it is suggested that lipomatous tumours with 8q11-13 rearrangement constitute a distinct pathogenetic entity. When selective therapies tailor-made against the specific pathogenetic rearrangement become available, it will become mandatory to pay more attention to the genetic constitution of the tumour cells than to their phenotypic appearance.
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Affiliation(s)
- Petter Brandal
- Department of Cancer Genetics, The Norwegian Radium Hospital, Oslo, Norway
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Murphey MD, Carroll JF, Flemming DJ, Pope TL, Gannon FH, Kransdorf MJ. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 2005; 24:1433-66. [PMID: 15371618 DOI: 10.1148/rg.245045120] [Citation(s) in RCA: 452] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Benign lipomatous lesions involving soft tissue are common musculoskeletal masses that are classified into nine distinct diagnoses: lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma or lipoblastomatosis, angiolipoma, myolipoma of soft tissue, chondroid lipoma, spindle cell lipoma and pleomorphic lipoma, and hibernoma. Soft-tissue lipoma accounts for almost 50% of all soft-tissue tumors. Radiologic evaluation is diagnostic in up to 71% of cases. These lesions are identical to subcutaneous fat on computed tomographic (CT) and magnetic resonance (MR) images and may contain thin septa. Lipomatosis represents a diffuse overgrowth of mature fat affecting either subcutaneous tissue, muscle or nerve, and imaging is needed to evaluate lesion extent. Lipoblastoma is a tumor of immature fat occurring in young children, and imaging features may reveal a mixture of fat and nonadipose tissue. Angiolipoma, myolipoma, and chondroid lipoma are rare lipomatous lesions that are infrequently imaged. Spindle cell and pleomorphic lipoma appear as a subcutaneous lipomatous mass in the posterior neck or shoulder, with frequent nonadipose components. Hibernoma appears as a lipomatous mass with serpentine vascular elements. Benign lipomatous lesions affecting bone, joint, or tendon sheath include intraosseous lipoma, parosteal lipoma, liposclerosing myxofibrous tumor, discrete lipoma of joint or tendon sheath, and lipoma arborescens. Intraosseous and parosteal lipoma have a pathognomonic CT or MR appearance, with fat in the marrow space or on the bone surface, respectively. Liposclerosing myxofibrous tumor is a rare intermixed histologic lesion commonly located in the medullary canal of the intertrochanteric femur. Benign lipomatous lesions may occur focally in a joint or tendon sheath or with diffuse villonodular proliferation in the synovium (lipoma arborescens) and are diagnosed based on location and identification of fat. Understanding the spectrum of appearances of the various benign musculoskeletal lipomatous lesions improves radiologic assessment and is vital for optimal patient management.
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Affiliation(s)
- Mark D Murphey
- Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Bldg 54, Rm M-133A, Washington, DC 20306, USA.
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O'Brien D, Aquilina K, Farrell M, Breathnach F, Allcutt D. Cervical lipoblastomatosis producing quadriparesis: case report of surgery with chemotherapy and 10-year follow-up. Childs Nerv Syst 2005; 21:165-70. [PMID: 15071750 DOI: 10.1007/s00381-004-0949-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2003] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Cervical lipoblastomatosis is a rare spinal tumour. Management of recurrence and long-term outcome data are not well described. CASE REPORT A 10-month-old infant presented with an upper extremity weakness. Magnetic resonance imaging (MRI) revealed an extradural cervical spinal tumour. It was debulked and histopathology revealed it to be lipoblastomatosis. The infant improved postoperatively. However, 5 months later the patient deteriorated and developed quadriparesis. The patient was managed with a more extensive resection and had chemotherapy. Ten years post-presentation the patient is well having made a full recovery and is living a normal life. Recent MRI shows minimal residual quiescent tumour. CONCLUSION The treatment of cervical lipoblastomatosis should involve the resection of as much tumour as possible at the first sitting as recurrence can be a problem. In cases of spinal recurrence we recommend aggressive decompression and adjuvant chemotherapy.
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Affiliation(s)
- Donncha O'Brien
- Department of Neurosurgery, Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Eaton Road, Liverpool, L12 2AP, UK.
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López-Ferrer P, Jiménez-Heffernan JA, Yébenes L, Vicandi B, Viguer JM. Fine-needle aspiration cytology of lipoblastoma: A report of two cases. Diagn Cytopathol 2004; 32:32-4. [PMID: 15584040 DOI: 10.1002/dc.20073] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lipoblastoma is an uncommon lipomatous tumor that typically occurs in infants and children. It may present as a single subcutaneous nodule or with multiple lesions (lipoblastomatosis). We describe fine-needle aspiration (FNA) cytologic features of two cases that presented as a subcutaneous lump in the scapular area and as a deeply located mass in the left arm. Smears showed fragments of adipose tissue that consisted of numerous vacuolated adipocytes with few stroma. Nuclei were small and located centrically, without indentations. Myxoid stromal material was a remarkable finding in one case. Both cases showed small delicate vessels, mainly in relation with the myxoid material. No necrosis, atypia, or mitotic figures were present. Cytologic features were characteristic enough to permit a specific diagnosis (adipose tumor suggestive of lipoblastoma). The differential diagnosis should consider lipoma with regressive changes, well-differentiated and mixoid liposarcoma. In addition to cytologic features, the patient's age is very useful for differentiation.
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Somers GR, Teshima I, Nasr A, Cook A, Khoury AE, Taylor GP. Intrascrotal Lipoblastoma With a Complex Karyotype: A Case Report and Review of the Literature. Arch Pathol Lab Med 2004; 128:797-800. [PMID: 15214818 DOI: 10.5858/2004-128-797-ilwack] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Lipoblastoma is a tumor of adipose tissue that usually occurs in young children. Most lipoblastomas occur on the extremities, trunk, and head and neck, and most have rearrangements of the 8q region. We describe a lipoblastoma in a 12-month-old boy who presented with a rapidly enlarging scrotal mass. Electron microscopy revealed features consistent with immature adipocytes, and cytogenetic analysis revealed the following karyotype: 57,XY,+4,+6,+7,der(8)t(8;12) (q22;q13), +der(8)t(8;12) (q22;q13), +9,+10,+12,−16,+17,+der(18)t(8;18)(q22;q23),+19,+20. Interestingly, the breakpoint on chromosome 12 (q13) is the same as that seen in lipoblastomas. To our knowledge, this is the first reported case of such a complex karyotype in lipoblastoma and adds to the expanding list of karyotypic abnormalities seen in such tumors.
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Affiliation(s)
- Gino R Somers
- Division of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada.
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Abstract
PURPOSE OF REVIEW Atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLs) are one of the more frequent mesenchymal neoplasms and are characterized by specific chromosome aberrations: supernumerary chromosome or giant marker chromosome or both. Extra copies of known oncogenes such as MDM2, CDK4, SAS, HMGA2 and others are present in this abnormal genetic material. RECENT FINDINGS In the past few years, several papers have further dissected the genetic alterations present in these tumors, allowing the identification of new potential oncogenes. SUMMARY ALT/WDLs represent therefore an interesting model for assessing the potential role of these oncogenes, not only in the pathogenesis, but also as a therapeutic target.
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Affiliation(s)
- Gianluigi Arrigoni
- Department of Pathology, San Raffaele Hospital, Via Olgettina 60, Milan, Italy
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