scholarly journals Well-differentiated spindle cell liposarcoma (‘atypical spindle cell lipomatous tumor’) does not belong to the spectrum of atypical lipomatous tumor but has a close relationship to spindle cell lipoma: clinicopathologic, immunohistochemical, and molecular analysis of six cases

2010 ◽  
Vol 23 (5) ◽  
pp. 729-736 ◽  
Author(s):  
Thomas Mentzel ◽  
Gabriele Palmedo ◽  
Cornelius Kuhnen
Keyword(s):  
Molecular Analysis ◽  
Spindle Cell ◽  
Spindle Cell Lipoma ◽  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Close Relationship ◽  
Well Differentiated

Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma With Features Mimicking Spindle Cell Lipoma

2019 ◽  
Vol 28 (3) ◽  
pp. 336-340 ◽  
Author(s):  
Judith A. S. Jebastin ◽  
Kyle D. Perry ◽  
Dhananjay A. Chitale ◽  
Michael P. Mott ◽  
Jessica Sanchez ◽  
...  
Keyword(s):  
Spindle Cell ◽  
Spindle Cell Lipoma ◽  
Rb1 Gene ◽  
Prognostic Features ◽  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Well Differentiated ◽  
Mdm2 Amplification ◽  
Lipomatous Tumors

Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and spindle cell lipoma are lipomatous tumors with distinct clinical, molecular, and prognostic features. Although histological and immunophenotypic features can overlap between ALT/WDL and spindle cell lipoma, the oncogenesis and clinical behavior are markedly different. In borderline cases, molecular analysis for MDM2 or CDK4 amplification can aid in distinguishing ALT/WDL from spindle cell lipoma. Although dedifferentiated liposarcoma has been reported to harbor both MDM2 amplification and loss of the RB1 region, we are not aware of a reported RB1 loss in well-differentiated ALT/WDL. In this article, we present a 69-year-old woman with a lipomatous tumor in the gluteal region that histologically, immunohistochemically, and molecularly mimicked spindle cell lipoma (with positive immunohistochemical staining for CD34 and loss of the RB1 gene region), yet harbored amplification of MDM2 and CDK4 confirmed by fluorescence in situ hybridization, supporting classification as ALT/WDL. This case strengthens the argument that in atypical clinical contexts, molecular studies for MDM2/CDK4 should be considered in tumors resembling spindle cell lipoma.

Atypical Spindle Cell Lipomatous Lesion Resected From Patient With History of CLL

2020 ◽  
Vol 86 (9) ◽  
pp. 1208-1211
Author(s):  
Chase J. Wehrle ◽  
J. Will Daigle ◽  
Asad Ullah ◽  
Suash Sharma ◽  
Edmond F. Ritter ◽  
...  
Keyword(s):  
Spindle Cell ◽  
Lymphocytic Leukemia ◽  
Left Shoulder ◽  
Spindle Cell Lipoma ◽  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Adipocytic Tumors ◽  
History Of ◽  
Pathologic Analysis ◽  
Mdm2 Amplification

Atypical spindle cell lipomatous neoplasm, also known as well-differentiated spindle cell liposarcoma, represents a newly discovered entity of adipocytic tumors. Recent research has shown this tumor variant to be more related to spindle cell lipoma, rather than the originally hypothesized atypical lipomatous tumor spectrum. Here we present a case of a 58-year-old man with a history of chronic lymphocytic leukemia with an enlarging mass on the posterior left shoulder, initially hypothesized to be a benign lipoma. However, magnetic resonance imaging showed a large, multiseptated, heterogeneous mass concerning for soft tissue sarcoma. After resection, pathologic analysis showed cells closely resembling spindle cell lipoma, with additional cellular and fascicular zones containing lipoblasts and mitotic figures. Molecular analysis showed no MDM2 amplification. This lack of amplification indicates this tumor is distinctly different from an atypical lipomatous tumor, which characteristically displays MDM2 amplification. However, tumor expression of RB1 was normal. The majority of atypical spindle cell lipomatous neoplasms are associated with RB1 deletions. We conclude that we have a unique example of an atypical spindle cell lipomatous tumor.

“Fat-Rich” (Spindle Cell-Poor) Variant of Atypical Spindle Cell/Pleomorphic Lipomatous Tumor: Striking Mimic of “Classical” Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma

2019 ◽  
Vol 27 (8) ◽  
pp. 868-871 ◽  
Author(s):  
David Creytens ◽  
Thomas Mentzel ◽  
Liesbeth Ferdinande ◽  
Joost van Gorp ◽  
Jo Van Dorpe ◽  
...  
Keyword(s):  
Spindle Cell ◽  
Molecular Genetic ◽  
Low Grade ◽  
Tissue Mass ◽  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Multinucleated Cells ◽  
Pericytic Mimicry ◽  
Well Differentiated ◽  
The Right

We report the case of a “fat-rich” (spindle cell-poor) variant of an atypical spindle cell/pleomorphic lipomatous tumor in a 63-year-old female patient presenting with a firm, painless soft tissue mass on the right hip. Atypical spindle cell/pleomorphic lipomatous tumor is a very recently described low-grade adipocytic neoplasm, which occurs predominantly in adults with a predilection for the limbs and limb girdles. In the present case, the diagnosis of an atypical spindle cell/pleomorphic lipomatous tumor was challenging because the tumor was almost exclusively composed of an atypical adipocytic component (resembling “classical” atypical lipomatous tumor/well-differentiated tumor) with only very focal presence of the diagnostic atypical morphologic features (atypical spindle-shaped cells, floret-like multinucleated cells, and “bizarre” pleomorphic [multinucleated] cells). The possibility of a “classical” atypical lipomatous tumor/well-differentiated liposarcoma was ruled out by immunohistochemistry (lack of MDM2 expression and loss of Rb expression) and molecular genetic testing (no amplification of MDM2 and presence of monoallelic deletion of RB1). Another interesting morphologic observation in this case was the striking perivascular location of the atypical spindle/pleomorphic cells in some areas (so-called “pericytic mimicry”). To our knowledge, pericytic mimicry has not been reported in the setting of an atypical spindle cell/pleomorphic lipomatous tumor.

scholarly journals Spindle Cell Lipoma of the Parapharyngeal Space: First Report of a Case

2001 ◽  
Vol 80 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Ingo Baumann ◽  
Florian Dammann ◽  
Hans Peter Horny ◽  
Peter Karl Plinkert
Keyword(s):  
Spindle Cell ◽  
Parapharyngeal Space ◽  
Subcutaneous Tissue ◽  
Resonance Imaging ◽  
Spindle Cell Lipoma ◽  
Lipomatous Tumor ◽  
Pharyngeal Muscles ◽  
Parapharyngeal Tumor ◽  
The Right ◽  
Total Parotidectomy

Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.

Orbital Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma Masquerading as Pleomorphic Lipoma

2019 ◽  
Vol 35 (3) ◽  
pp. e76-e80 ◽  
Author(s):  
Kyle McKey ◽  
Paul J. L. Zhang ◽  
Carol L. Shields ◽  
Sara E. Lally ◽  
Ralph C. Eagle ◽  
...  
Keyword(s):  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Pleomorphic Lipoma ◽  
Well Differentiated

scholarly journals A Retrospective Study of Superficial Type Atypical Lipomatous Tumor

2020 ◽  
Vol 7 ◽  
Author(s):  
Emi Mashima ◽  
Yu Sawada ◽  
Natsuko Saito-Sasaki ◽  
Kayo Yamamoto ◽  
Shun Ohmori ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Tumor Size ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Tumor Location ◽  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Physical Examinations ◽  
Superficial Type ◽  
Well Differentiated

Atypical lipomatous tumor (ALT) has been defined as a well-differentiated liposarcoma exhibiting a higher frequency of a local recurrence after surgical resection. ALT is mainly classified into deep type and superficial type. Compared with deep type ALT, superficial type ALT is rarely observed. One of the most important issues is that little has been known about superficial type ALT and it is not easy to predict the presence of superficial type ALT before surgical resection. To clarify the clinical manifestations of superficial type ALT, we examined 15 cases with superficial type ALT and 118 cases with benign lipoma, and analyzed their differences in clinical characteristics and the findings of MRI test. In clinical characteristics, the tumor size of superficial type ALT was significantly greater than that of benign lipoma, and superficial type ALT showed a significantly higher frequency of the tumor size of more than 4 cm. Superficial type ALT exhibited poor tumor mobility and hardness with elastic soft. In addition, a significantly higher frequency of tumor location of superficial type ALT was observed in extremities. Among tumor sites at the trunk, buttocks, and shoulder were high frequent location in superficial type ALT. In an MRI examination, superficial type ALT exhibited a significantly higher frequency of the septal structures compared with benign lipoma. The combinations of clinical characteristics, including physical examinations, MRI, and histological examinations, are helpful for the diagnosis of superficial type ALT.

scholarly journals FluorescenceIn SituHybridization forMDM2Amplification as a Routine Ancillary Diagnostic Tool for Suspected Well-Differentiated and Dedifferentiated Liposarcomas: Experience at a Tertiary Center

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Khin Thway ◽  
Jayson Wang ◽  
John Swansbury ◽  
Toon Min ◽  
Cyril Fisher
Keyword(s):  
Gene Amplification ◽  
Diagnostic Tool ◽  
Spindle Cell ◽  
Significant Group ◽  
Lipomatous Tumor ◽  
Tertiary Center ◽  
Benign Histology ◽  
Well Differentiated ◽  
Correlation Rate

Background. The assessment ofMDM2gene amplification by fluorescencein situhybridization (FISH) has become a routine ancillary tool for diagnosing atypical lipomatous tumor (ALT)/well-differentiated liposarcoma and dedifferentiated liposarcoma (WDL/DDL) in specialist sarcoma units. We describe our experience of its utility at our tertiary institute.Methods. All routine histology samples in whichMDM2amplification was assessed with FISH over a 2-year period were included, and FISH results were correlated with clinical and histologic findings.Results. 365 samples from 347 patients had FISH forMDM2gene amplification. 170 were positive (i.e., showedMDM2gene amplification), 192 were negative, and 3 were technically unsatisfactory. There were 122 histologically benign cases showing a histology:FISH concordance rate of 92.6%, 142 WDL/DDL (concordance 96.5%), and 34 cases histologically equivocal for WDL (concordance 50%). Of 64 spindle cell/pleomorphic neoplasms (in which DDL was a differential diagnosis), 21.9% showedMDM2amplification. Of the cases with discrepant histology and FISH, all but 3 had diagnoses amended following FISH results. For discrepancies of benign histology but positive FISH, lesions were on average larger, more frequently in “classical” (intra-abdominal or inguinal) sites for WDL/DDL and more frequently core biopsies. Discrepancies of malignant histology but negative FISH were smaller, less frequently in “classical” sites but again more frequently core biopsies.Conclusions. FISH has a high correlation rate with histology for cases with firm histologic diagnoses of lipoma or WDL/DDL. It is a useful ancillary diagnostic tool in histologically equivocal cases, particularly in WDL lacking significant histologic atypia or DDL without corresponding WDL component, especially in larger tumors, those from intra-abdominal or inguinal sites or core biopsies. There is a significant group of well-differentiated adipocytic neoplasms which are difficult to diagnose on morphology alone, in which FISH forMDM2amplification is diagnostically contributory.

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