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PubMedDate not supplied

[Myxoid liposarcoma and pleomorphic liposarcoma: cyto-histological correlations].

Myxoid liposarcoma and pleomorphic liposarcoma: cito-histological correlations. A correlative cytologic and histologic study of a myxoid liposarcoma of the shoulder in a 72 year-old man and a pleomorphic liposarcoma observed in the retroperitoneum of a 84 year-old woman, are presented. A preoperative FNAB cytology performed in both cases showed necrotic material containing spindle-stellate shaped cells, interspersed in a myxoid matrix, with rare classical monovacuolated lipoblasts and fragments of plessiform vessels were seen in the first and scattered pleomorphic and multinucleated cells, with prominent nucleoli and numerous atypical mitosis in the second. A malignant mesenchimal spindle-cells tumor, with myxoid matrix and pleomorphic cells, consistent with liposarcoma, respectively were suspected. Gross and histological specimens confirmed the cytological suspect. Authors discuss main cyto-histological differential diagnoses of myxoid tumors, and point out the importance and a correct differentiation between myxoid liposarcoma and intramuscular myxoma. The cytologic appearance of pleomorphic liposarcoma is similar to histologic type and therefore the problem of a differential diagnosis with soft tissue tumors is analogous. When mono or plurivacuolated lipoblasts are absent, differential diagnosis between pleomorphic histiocytoma and liposarcoma is impossible. Nevertheless this is not a important problem at cytological level because both tumors have a had prognosis and must be treated with radical surgery. Definition of correct histologic type will be more suitable on histologic specimens.

Aged↗

PubMed1979

Atypical lipoma, atypical intramuscular lipoma, and well differentiated retroperitoneal liposarcoma: a reappraisal of 30 cases formerly classified as well differentiated liposarcoma.

Thirty cases formerly diagnosed as Grade I lipogenic liposarcoma (well differentiated liposarcoma) were reviewed. The basic histologic pattern in all was that of adult fat modified by the presence of cells with enlarged, hyperchromatic nuclei; in most cases there was also a component of myxoid and/or fibrous tissue. The length of follow-up ranged from two to 30 years. Nine of the tumors were located in the subcutaneous layer. None of these recurred after excision, not even those which were simply "shelled out," and none metastasized. The term "atypical lipoma" is proposed for this group. Thirteen were located within or between muscles of the limbs, limb girdles, and head and neck. Nine of these recurred at least one, but there were no metastases and no deaths due to tumor. These were designated "atypical intramuscular lipoma." The remaining eight originated in the retroperitoneum. Although none of these patients developed metastases, five suffered inoperable recurrence and three died as a result of the neoplasm. It is suggested that the term "well differentiated retroperitoneal liposarcoma" be retained for cases of this type.

Adult↗

PubMed1989

[Liposarcoma of the spermatic cord. Review of the literature. Apropos of a case of myxoid liposarcoma].

Based on one case of spermatic cord liposarcoma, the authors mention the different histological types of this lesion. A review of the literature confirms this rare tumor typically occurs in the adult population; the majority of spermatic cord liposarcomas are of low grade malignancy. The treatment of choice remains radical orchidectomy with wide excision of the tumor. Because of the predilection of this lesion for local recurrence, the patients must be followed periodically.

Genital Neoplasms, Male↗

PubMed1989

A clinicopathologic comparison of malignant fibrous histiocytoma and liposarcoma.

The diagnosis of MFH depends on the demonstration of histiocytic and fibroblastic functions. MFHs may phagocytose fat; therefore, lipid stains are useless. By electron microscopy, cytoplasmic lipid is membrane-bound. Immunohistochemical staining for vimentin and histiocytic markers may be helpful. Liposarcoma is diagnosed only when there is convincing evidence of synthesis and storage of fat by the tumor cells. By electron microscopy, cytoplasmic lipid is nonmembrane-bound. Both MFH and liposarcoma have subtypes. In MFH, the pleomorphic forms are the most common. Myxoid MFH is less common; all other types are rare. In liposarcoma, the myxoid types are by far the most common. The myxoid types of both MFH and liposarcoma may contain other elements that vary in degree and geographic distribution and that can raise the histologic grade. About 50% of liposarcomas are low-grade tumors; these are almost always purely myxoid. Low-grade myxoid liposarcoma has a much better prognosis than other types. Myxoid liposarcoma has a better prognosis than myxoid MFH. The peak incidence of MFH is in the seventh decade of life whereas that of liposarcoma is in the fifth decade. A substantial number (roughly 25% to 30%) of MFHs occur in the subcutaneous tissue. Clinically they are almost invariably mistaken for ganglion cysts. Liposarcoma, however, is likely to occur in or below the buttocks. Most are in the anterior thigh. Subcutaneous liposarcoma is extremely rare. A tumor in this area is likely to be either a more malignant myxoid MFH or one of the benign atypical lipomatous tumors. In both MFH and liposarcoma, the development of distant lesions is related to the tumor's histologic grade and size and to local recurrence. Favored metastatic sites of MFH are lung and lymph nodes. Favored sites of distant lesions in the myxoid/round cell types of liposarcoma are intra-abdominal, retroperitoneal, other soft-tissue areas (especially in the neck), and bone. Lymph node involvement is very rare. Because myxoid/round cell liposarcomas have a marked propensity to involve intra-abdominal sites, abdominal computed tomography and bone scan are recommended in the initial evaluation and follow-up of high-risk patients (those with high-grade tumors larger than 15 cm and those with local recurrence of intermediate- or high-grade tumors of any size).

Diagnosis, Differential↗

PubMed1979

The ultrastructure of liposarcoma. A study of 10 cases.

An ultrastructural study of 10 liposarcomas is reported. Four of the liposarcomas were wholly or predominantly of well-differentiated, lipoma-like or fibrosing type, 3 of myxoid type, 2 of round cell type and 1 pleomorphic type. The well-differentiated, lipoma-like liposarcomas showed cells with a few, large lipid droplets, few organelles and a peripherally located, fairly large nucleus, The well-differentiated liposarcomas of fibrosing type revealed mostly spindle-shaped, fibroblast-like cells, with abundant rough endoplasmic reticulum and inconspicuous lipid inclusions, surrounded by collagen. One well-differentiated liposarcoma contained an area which was similar to brown adipose tissue and hibernoma. The spindle and stellate shaped cells of the myxoid liposarcomas showed abundant rough endoplasmic reticulum and large smooth-membraned vacuoles filled with moderately dense amorphous material, which appeared to be extruded extracellularly by rupture of the vacuoles. Cytoplasmic lipid droplets were seen in most cells but were much less prominent than in the well-differentiated lipoma-like liposarcomas. Ultrastructurally there were many similarities between the myxoid and round cell liposarcoma, indicating a close relationship between the two types. The pleomorphic liposarcoma revealed cells with one or more large, irregular nuclei, numerous large vacuoles after dissolved lipids, abundant dilated cisternae of rough endoplasmic reticulum and rounded, electron-dense bodies corresponding to PAS-positive hyalin globules seen in the light microscope. The ultrastructural study suggests that the variegated cellular appearance of the different subtypes of liposarcoma reflects the wide cellular spectrum seen during the differentiation of adipose tissue and supports the view that all liposarcomas histogenetically represent a single entity.

Adipose Tissue↗

PubMed1989

The prognostic value of histologic subtypes in primary extremity liposarcoma.

Patients with a localized primary liposarcoma of the extremity who were treated in Memorial Sloan-Kettering Cancer Center between 1968 and 1978 were studied. The prognosis of patients with extremity liposarcoma was analyzed according to histopathologic subtypes. A system of five subtypes was used; well-differentiated, myxoid, fibroblastic, lipoblastic, and pleomorphic liposarcomas. The 5-year treatment failure rates and survival rates were, respectively, 30% and 100% for well-differentiated, 25% and 88% for myxoid, 60% and 58% for fibroblastic, 100% and 40% for lipoblastic, and 64% and 56% for pleomorphic liposarcomas. Although local recurrence was present in all five subtypes, a significant increment in local failure was seen in patients with high-grade liposarcomas. Distant metastasis after the initial operation was not found in patients with well-differentiated liposarcoma and rare in the patients with myxoid liposarcoma. In contrast, 50% of the patients with fibroblastic, lipoblastic, and pleomorphic liposarcoma had a distant relapse within 5 years.

Adolescent↗

PubMed1989

Composition of fat in different types of liposarcomas in comparison with lipomas.

Different types of liposarcomas, and for comparison, lipomas were investigated for their lipid composition. Triglycerides were the main components of lipomas and lipoma-like liposarcomas. Myxoid liposarcomas had a high water content and contained considerable amounts of free cholesterol and phospholipids. One pleomorphic liposarcoma resembled a myxoid liposarcoma in its lipid composition and water content. In 4 liposarcomas of mixed type the lipid composition resembled the main subtype. A glycerol ether-like fraction was found in all lipoma-like (well differentiated) liposarcomas, in one myxoid type but not in the other types.

Chemical Fractionation↗

PubMed1975

Liposarcoma a clinicopathologic, radiographic and prognostic study.

The present investigation is a clinicopathologic, radiologic and prognostic study of 122 liposarcomas registered in the Swedish Cancer Registry between 1958 and 1966. The incidence of liposarcoma in Sweden was estimated to be 2.5 cases per million inhabitants per year. The liposarcomas were divided into 4 main subtypes according to WHO's recommended classification (1969): well-differentiated (33 cases), myxoid (22 cases), rundcell (14 cases) and pleomorphic types (21 cases). When predominantly well-differentiated or myxoid liposarcomas contained areas of round-cell or pleomorphic types (24 and 8 cases, respectively), they were classified separately, thus adding 2 further subtypes to our classification. The validity of this histologic classification was emphasized by the prognostic study, based on a 10 year follow-up. The differential diagnosis for each of the 4 main subtypes is discussed. Three well-differentiated, lipoma-like liposarcomas which contained highly vascular hibernoma-like areas are described. Two well-differentiated liposarcomas situated in the neck and upper part of the back, respectively, of elderly patients included area similar to "spindle-cell lipoma" (Enzinger). An intracytoplasmic network of birefringent fibers with the staining reaction of collagen was found in 2 well-differentiated fibrosing liposarcomas...

Adolescent↗

PubMed1992

Cytogenetic findings in liposarcoma correlate with histopathologic subtypes.

The cytogenetic findings in 31 liposarcomas from 26 patients are reported. Four other tumors did not grow. Three histologic types are represented in this analysis. The well-differentiated liposarcomas were characterized by telomeric associations, large marker chromosomes and ring chromosomes, and in some cases, double minutes. The pleomorphic liposarcomas contained very high clonal chromosomal numbers with near-tetraploid modes and numerous variable, often unidentifiable, chromosomal abnormalities. The myxoid liposarcomas were characterized primarily by a t(12;16)(q13;p11) as the sole abnormality or additional changes. These results indicate that cytogenetic findings may provide a new criterion, not only for establishing the diagnosis of liposarcoma, but also for differentiating confusing histologic types of liposarcoma and these lesions from other types of sarcomas.

Aged↗

PubMed1990

Myxoid liposarcoma: magnetic resonance imaging appearances with clinical and histological correlation.

Myxoid liposarcoma is the most common type of liposarcoma. The magnetic resonance imaging (MRI) features of this tumor were evaluated and correlated with its clinical and histological features in seven patients to determine under what circumstances the tumor should be considered in differential diagnosis and why its signal intensity differs from those of lipoma and lipoma-like (lipoblastic) liposarcoma. In all patients the tumor presented in a lower extremity (5 thigh, 2 calf) as a painless, slowly growing mass which had been present for several months to several years. MRI examination revealed the tumors to be encapsulated, noninfiltrating, and usually septated. On T1-weighted sequences five of seven lesions (71%) showed lacy, amorphous, or linear foci of high signal within a low signal mass. These foci are believed to represent fat within the tumor and distinguish it from several other benign and malignant masses. If an indolent mass in a lower extremity demonstrates a predominantly low signal with a few amorphous or linear high signal foci on T1-weighted sequences, one should consider the possibility of myxoid liposarcoma even if it appears benign by all other criteria. Histologic evaluation showed that myxoid liposarcomas contain less than 10% mature fat, which accounts for their low signal on T1-weighted sequences in contrast to the high signal of lipomas and lipoblastic liposarcomas.

Connective Tissue↗

PubMed1991

[Retroperitoneal mixed type liposarcoma: a case report].

Primary retroperitoneal tumors are reported to account for 0.2% of all malignancies. Furthermore, 10-20% of all primary retroperitoneal tumors are liposarcomas. Up to 1989, 213 cases of retroperitoneal liposarcoma have been reported in the Japanese literature to our knowledge. Mixed type liposarcomas were rare, and composed 13.8% of all retroperitoneal liposarcomas in this series. We described here a case of retroperitoneal mixed type liposarcoma. A 50-year-old man was admitted to our department with a mass in the left abdomen. Computed tomography and aortography revealed a huge and hypovascular tumor in the retroperitoneal cavity, not containing fat tissue. It was diagnosed as a retroperitoneal tumor and treated surgically. The tumor and the left kidney were encapsulated and could be removed en bloc. The size and weight of the tumor were 28 x 18 x 12 cm and 3,100 g, respectively. Histological examination of the mass proved it to be a mixed type liposarcoma. He was administered OK-432 as adjuvant therapy. After 11 months, bone metastasis to the vertebra appeared. Moreover, lung metastasis also occurred and he died of the disease 15 months after the operation.

Combined Modality Therapy↗

PubMed1990

Myxoid liposarcoma with t(12;16) (q13;p11) contains site-specific differences in methylation patterns surrounding a zinc-finger gene mapped to the breakpoint region on chromosome 12.

The q13 to q15 region of human chromosome 12 is frequently and consistently rearranged in malignant and benign adipose tissue tumors as well as benign tumors of smooth muscle and salivary glands. A reciprocal translocation, (12;16) (q13;p11), is characteristic of the myxoid subtype of liposarcoma, whereas translocations within 12q13-14 are frequently observed in benign lipomas. We are using pulsed-field gel electrophoresis to study the 12q13-q14 region in order to detect and clone the respective translocation breakpoints in these tumors. The locus GLI, which encodes a zinc-finger protein, has been mapped to the same region as the myxoid liposarcoma breakpoint. Pulsed-field analysis of myxoid liposarcoma and lipoma DNA has allowed us to construct a 600-kilobase physical map surrounding the GLI locus, which shows that breakpoints in both types of tumor are outside this region. However, myxoid liposarcoma DNA samples contained altered restriction fragments detectable with GLI probes that were highly specific and reproducible from case to case. These altered fragments are due to highly specific and reproducible methylation differences that are unique to myxoid liposarcoma DNA. These methylation changes may prove to be useful clinically as a diagnostic tool to differentiate subtypes of liposarcoma.

Cell Line↗

PubMed1978

Liposarcoma of the neck: a clinicopathologic study of 4 cases.

A clinicopathological study of 4 patients with liposarcoma in the neck treated surgically is presented. Three of the liposarcomas were located in the supraclavicular region, two to the right one to the left, and one appeared to the left in the back of the neck. Liposarcoma rarely involves the head and neck region. A survey is given of the few reported liposarcomas in this region. Two of the tumors in the present series were well differentiated, one of which recurred repeatedly. The other two tumors were round-cell and pleomorphic in type, both of which recurred. At the end of follow-up 11 and 9 years, the two patients with well-differentiated liposarcomas were alive. The other two patients had died after 5 and 4 years from intercurrent disease and metastatic spread, respectively. The histopathological basis for the diagnosis, distinguishing features of intramuscular (infiltrating) lipoma, hibernoma and spindle cell lipoma, as well as the treatment, are discussed.

Adult↗

PubMed1977

Liposarcoma of the oropharyngeal region. Review of the literature and report of two cases.

Liposarcomas of the oropharyngeal regions are exceedingly rare. Their silent, slow growth, submucosal or deep location, circumscription, and firm but resilient texture often suggest a diagnosis of a cyst or benign soft-tissue neoplasm. Two cases of well-differentiated myxoid liposarcoma are presented. The literature of over half a century was reviewed, and all documented cases were critically analyzed. The clinical data correlated with the histopathology and biologic behavior of the tumors indicated that two thirds of all liposarcomas of the head and neck are of the myxoid type. The well-differentiated myxoid liposarcoma was the most common one and has an over-all favorable prognosis. Lipomas of the oropharyngeal regions are relatively common and small, generally not exceeding 2.5 cm. in greatest diamter. A lobulated firm tumor of fast tissue significantly exceeding this size should be strongly suspected of being a liposarcoma.

Adult↗

PubMed1992

Chromosome abnormalities in liposarcomas.

We performed a cytogenetic study of short-term cultures from fresh surgical specimens obtained from four patients with liposarcoma. Myxoid liposarcomas (cases 1-3) were associated with a specific translocation between chromosomes 12 and 16. Trisomy 8, a nonrandom secondary aberration in myxoid liposarcoma, was observed in the third case as the only additional change. Round cell liposarcoma (case 4) showed complex chromosomal aberrations affecting chromosomes 1, 2, 5, 6, 7, 13, 14, 17, 19, and 22. Neither band 12q13 nor 16p11 was visibly rearranged. Three subgroups of liposarcomas are proposed. The first group is characterized by t(12;16)(q13;p11), the second group by ring chromosomes, telomeric associations, and giant markers, and the last by complex numerical and structural aberrations.

Adult↗

PubMed1990

Primary liposarcoma of the jejunum.

The rare case of a primary liposarcoma of the jejunum in a 52-year-old man is described. The main tumor mass was located within the submucosa and caused chronic subileus by subtotal obstruction of the jejunum. The histology showed a mixed type liposarcoma. In the main mass features of well differentiated lipoma-like and sclerosing liposarcoma predominated. In the tumor periphery they were combined with areas of pleomorphic liposarcoma, consisting of tightly packed giant lipoblasts. After an incomplete resection well differentiated sclerosing and pleomorphic liposarcoma recurred within the intestinal wall and in the mesentery near the primary anastomosis. The unusual primary site and pattern of spread of the tumor are discussed and the literature is reviewed.

Humans↗

PubMedDate not supplied

MR imaging of liposarcomas: correlation of MR features and histology.

The magnetic resonance (MR) imaging features of liposarcoma were correlated with histology in 15 patients. The MR findings for liposarcoma were not specific. The six myxoid liposarcomas and two atypical lipomatous tumors, however, had distinctive MR features, i.e., nodular masses of slightly heterogeneous intermediate to high signal intensity (SI), intermingled with high SI septa on T1-weighted images. The T2-weighted images demonstrated the relative reversal of these regional SI characteristics. Additionally, MR correctly identified the presence of fat in all eight cases in which it was pathologically present. The fat in two atypical lipomatous tumors was inseparable on MR from the subcutaneous fat. Magnetic resonance appears useful for preoperative staging and follow-up studies of liposarcomas. It may be helpful in identifying patients with myxoid liposarcoma and atypical lipomatous tumors who have longer survival times.

Adult↗

PubMedDate not supplied

Grading liposarcomas with PET using [18F]FDG.

Five patients with liposarcomas of the thigh were studied using positron emission tomography (PET) with [18F]2-deoxy-2-fluoroglucose (FDG). There were three low-grade tumors (all National Cancer Institute Grade 1 myxoid liposarcomas) and two high-grade tumors (both pleomorphic liposarcomas, Grades 2 and 3). The low-grade liposarcomas were easily identified with an average dose uptake ratio (DUR) of 1.38 +/- 0.045 (mean +/- SD). The high-grade lesions were more avid for FDG with a mean DUR of 2.45 +/- 0.24. There was a significant difference (p = 0.004) in the DUR for the two groups and the histological grade of malignancy was highly correlated with the DUR for FDG (Rho = 0.89). These findings suggest that FDG-PET may be useful for distinguishing between low-grade and high-grade liposarcomas.

Deoxyglucose↗