Cytodiagnosis of dedifferentiated liposarcoma clinically masquerading as a renal tumour

Misra, Vatsala; Singh, Pradyumn; Ahmad, Shabi

doi:10.1111/j.1365-2303.2008.00557.x

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…These touch preparations/aspirate smears can shed light on the mesenchymal nature of a clinically suspected renal neoplasm and help to inform management decisions, especially when lipoblasts are seen. 32 While identification of lipoblasts can be highly informative, from one large cytology study of adult liposarcomas lipoblasts were seen in only 47% of cases. 33 In that series, the authors acknowledged inherent pitfalls to cytological evaluation of mesenchymal sarcomas and strongly advised clinicopathological correlation in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…On some renal/perirenal mass biopsies, cytological assessment is concurrently performed. These touch preparations/aspirate smears can shed light on the mesenchymal nature of a clinically suspected renal neoplasm and help to inform management decisions, especially when lipoblasts are seen 32 . While identification of lipoblasts can be highly informative, from one large cytology study of adult liposarcomas lipoblasts were seen in only 47% of cases 33 .…”

Section: Discussionmentioning

confidence: 99%

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Diagnosing liposarcoma on (peri)‐renal mass biopsy: A clinicopathological study of 30 cases

Potterveld,

Mubeen,

Anderson

et al. 2024

Histopathology

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AimsClassification of renal neoplasms on small tissue biopsies is in increasing demand, and maintaining broad differential diagnostic considerations in this setting is necessary. When evaluating a renal or perirenal tumour biopsy with sarcomatoid morphology, together with sarcomatoid renal cell carcinoma and sarcomatoid urothelial carcinoma as top diagnostic considerations, it is vital to additionally consider the possibility of well‐differentiated and de‐differentiated liposarcoma.Methods and resultsThis study reports a series of 30 biopsy samples from sites in or around the kidney collected from four institutions in which the correct diagnosis was either well‐differentiated or de‐differentiated liposarcoma. The majority (26 of 30, 87%) of lesions were accurately diagnosed on biopsy sampling, all of which incorporated testing for MDM2 by immunohistochemistry (IHC), fluorescence in‐situ hybridisation (FISH) or a combination of the two as part of the diagnostic work‐up. Tumour expression of MDM2 by IHC without confirmatory FISH analysis was sometimes (30%) sufficient to reach a diagnosis, but demonstration of MDM2 amplification by FISH was ascertained in the majority (57%) of biopsy samples. A diagnosis of de‐differentiated liposarcoma was not definitively established until resection in four (13%) patients, as no MDM2 testing was performed on the corresponding pre‐operative biopsies.ConclusionsWhen a retroperitoneal tumour is not clinically suspected, histological consideration of a liposarcoma diagnosis may be overlooked. Implementation of ancillary immunohistochemical and cytogenetic testing can ultimately lead to a definitive diagnosis in this potentially misleading anatomical location.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnosing liposarcoma on (peri)‐renal mass biopsy: A clinicopathological study of 30 cases

Potterveld,

Mubeen,

Anderson

et al. 2024

Histopathology

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“…In the cytology literature, there are only rare case reports of dedifferentiated LPS diagnosed on cytological material,[11] and to our knowledge, this is the first case report of a dedifferentiated LPS diagnosed by FNA with FISH studies performed on cytological material to confirm amplification of the MDM2 oncogene.…”

Section: Introductionmentioning

confidence: 99%

Fine needle aspiration biopsy diagnosis of dedifferentiated liposarcoma: Cytomorphology and MDM2 amplification by FISH

et al. 2010

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Lipomatous mesenchymal tumors constitute the most common type of soft tissue tumors. Well-differentiated liposarcoma (WDLS) can undergo dedifferentiation to a nonlipogenic sarcoma of variable histologic grade. In the recent literature, amplification of the murine double minute 2 (MDM2) oncogene, which has a role in cell cycle control, has been successful in distinguishing WDLS from benign lesions. We present a case of dedifferentiated liposarcoma diagnosed by fine-needle aspiration (FNA), using cytomorphology and ancillary studies (immunocytochemistry and fluorescent in-situ hybridization). An 85-year old female presented to our institution with a firm soft tissue mass of the right buttock. The FNA showed atypical spindle cells, osteoclast-like giant cells and extracellular dense matrix material. The cell block showed cellular groups of highly atypical spindle cells with osteoid and adipose tissue. Fluorescence in situ hybridization (FISH) studies performed on the cell block demonstrated amplification of the MDM2 gene. In addition, the findings were morphologically compatible with the previously resected retroperitoneal dedifferentiated liposarcoma with areas of osteosarcoma. This rare case illustrates the usefulness of FNA and ancillary studies in the diagnosis and subclassification of soft tissue tumors. To the best of our knowledge, this is the first report of MDM2 FISH positivity in a liposarcoma diagnosed by FNA.

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Update on Liposarcoma: A review for cytopathologists

Dodd

2011

Diagnostic Cytopathology

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Liposarcoma (LS) represents the most common type of soft tissue sarcoma. LS is subdivided into four distinct subtypes: well-differentiated, myxoid/round cell, pleomorphic, and mixed LS. In addition to distinctive morphology, each of the subgroups has a different prognosis and treatment strategy. While subgrouping has traditionally been based on conventional morphology, recent molecular and cytogenetic findings have validated the current classification system. Well-differentiated LS is characterized by overexpression of MDM2, which blocks the tumor suppressor function of p53. Myxoid/round cell LS is characterized by a specific translocation resulting in a fusion protein which interferes with adipocyte differentiation. Pleomorphic LS, like other high grade sarcomas, is characterized by multiple chromosomal abnormalities. Each of these distinctive molecular signatures can be exploited to aid in the subtyping of LS and in distinguishing true sarcomas of lipogenic derivation from benign mimics.

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Cytodiagnosis of dedifferentiated liposarcoma clinically masquerading as a renal tumour

Cited by 5 publications

References 7 publications

Diagnosing liposarcoma on (peri)‐renal mass biopsy: A clinicopathological study of 30 cases

Diagnosing liposarcoma on (peri)‐renal mass biopsy: A clinicopathological study of 30 cases

Fine needle aspiration biopsy diagnosis of dedifferentiated liposarcoma: Cytomorphology and MDM2 amplification by FISH

Update on Liposarcoma: A review for cytopathologists

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