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Aliaga E, Orosz Z, Michal M, Melegh Z. A lipomatous tumour of the paratesticular region: fibrosarcoma-like lipomatous neoplasm or lipoblastoma-like tumour? Histopathology 2024; 84:411-413. [PMID: 37771086 DOI: 10.1111/his.15057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Affiliation(s)
- Elizabeth Aliaga
- Cellular Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Zsolt Orosz
- Department of Histopathology, Nuffield Orthopaedic Centre, Oxford, UK
| | - Michael Michal
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
- Biomedical Center, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic
- Bioptical Laboratory, Ltd., Plzen, Czech Republic
| | - Zsombor Melegh
- Department of Surgical and Molecular Pathology, National Institute of Oncology, Budapest, Hungary
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2
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Lanceta J, Tripodi J, Karp L, Shaham M, Mahmood N, Najfeld V, Edelman M, Cohen N. Chromothripsis in lipoblastoma: second reported case with complex PLAG1 rearrangement. Mol Cytogenet 2023; 16:32. [PMID: 38012697 PMCID: PMC10683218 DOI: 10.1186/s13039-023-00665-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
Lipoblastomas (LPBs) are rare benign neoplasms derived from embryonal adipose that occur predominantly in childhood. LPBs typically present with numeric or structural rearrangements of chromosome 8, the majority of which involve the pleomorphic adenoma gene 1 (PLAG1) proto-oncogene on chromosome 8q12. Here, we report on a LPB case on which showed evidence of chromothripsis. This is the second reported case of chromothripsis in LPB.
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Affiliation(s)
- Joel Lanceta
- Department of Pathology and Laboratory Medicine, Northwell Health/Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, New York, USA.
| | - Joseph Tripodi
- Tumor CytoGenomics, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lynne Karp
- Department of Pathology and Laboratory Medicine, Northwell Health/Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, New York, USA
- Division of Cytogenetics and Molecular Pathology, North Shore University Hospital, Manhasset, NY, USA
| | - Meira Shaham
- Department of Pathology and Laboratory Medicine, Northwell Health/Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, New York, USA
- Division of Cytogenetics and Molecular Pathology, North Shore University Hospital, Manhasset, NY, USA
| | - Nayyara Mahmood
- Department of Pathology and Laboratory Medicine, Northwell Health/Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, New York, USA
- Division of Cytogenetics and Molecular Pathology, North Shore University Hospital, Manhasset, NY, USA
| | - Vesna Najfeld
- Tumor CytoGenomics, Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Morris Edelman
- Department of Pathology and Laboratory Medicine, Northwell Health/Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, New York, USA
- Division of Pediatric Pathology, Cohen Children's Medical Center, New Hyde Park, NY, USA
| | - Ninette Cohen
- Department of Pathology and Laboratory Medicine, Northwell Health/Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, New York, USA
- Division of Cytogenetics and Molecular Pathology, North Shore University Hospital, Manhasset, NY, USA
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Parkash V, Aisagbonhi O, Riddle N, Siddon A, Panse G, Fadare O. Recent Advances in the Classification of Gynecological Tract Tumors: Updates From the 5th Edition of the World Health Organization "Blue Book". Arch Pathol Lab Med 2023; 147:1204-1216. [PMID: 36596270 DOI: 10.5858/arpa.2022-0166-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 01/04/2023]
Abstract
CONTEXT.— The World Health Organization Classification of Tumours: Female Genital Tract Tumors, 5th edition, published in September 2020, comes 6 years after the 4th edition, and reflects the monumental leaps made in knowledge about the biology of gynecological tumors. Major changes include revised criteria for the assignment of the site of origin of ovarian and fallopian tube tumors, a revision in the classification of squamous and glandular lesions of the lower genital tract based on human papillomavirus association, and an entire chapter devoted to genetic tumor syndromes. This article highlights the changes in the 5th edition relative to the 4th edition, with a focus on areas of value to routine clinical practice. OBJECTIVE.— To provide a comprehensive update on the World Health Organization classification of gynecological tumors, highlighting in particular updated diagnostic criteria and terminology. DATA SOURCES.— The 4th and 5th editions of the World Health Organization Classification of Tumours. CONCLUSIONS.— The World Health Organization has made several changes in the 5th edition of the update on female genital tumors. Awareness of the changes is needed for pathologists' translation into contemporary practice.
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Affiliation(s)
- Vinita Parkash
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
| | - Omonigho Aisagbonhi
- Department of Pathology, University of California at San Diego, La Jolla, California (Aisagbonhi, Fadare)
| | - Nicole Riddle
- The Department of Pathology and Cell Biology, Ruffolo, Hooper, and Associates, University of South Florida College of Medicine, Tampa, Florida (Riddle, Siddon)
| | - Alexa Siddon
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
- Department of Laboratory Medicine (Siddon), Yale University School of Medicine, New Haven, Connecticut
- The Department of Pathology and Cell Biology, Ruffolo, Hooper, and Associates, University of South Florida College of Medicine, Tampa, Florida (Riddle, Siddon)
| | - Gauri Panse
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
- The Department of Dermatology (Panse), Yale University School of Medicine, New Haven, Connecticut
| | - Oluwole Fadare
- Department of Pathology, University of California at San Diego, La Jolla, California (Aisagbonhi, Fadare)
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Anderson WJ, Mariño-Enríquez A, Trpkov K, Hornick JL, Nucci MR, Dickson BC, Fletcher CDM. Expanding the Clinicopathologic and Molecular Spectrum of Lipoblastoma-Like Tumor in a Series of 28 Cases. Mod Pathol 2023; 36:100252. [PMID: 37355153 DOI: 10.1016/j.modpat.2023.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023]
Abstract
Lipoblastoma-like tumor (LLT) is a rare adipocytic neoplasm with a predilection for the vulva. Since 2002, <30 cases have been reported, characterizing it as an indolent tumor that may sometimes recur locally. Diagnosis can be challenging due to its rarity and morphologic overlap with other adipocytic tumors. Thus far, there are no specific molecular or immunohistochemical features to aid in the diagnosis of LLT. Recent case reports have described LLT arising at other sites, including the spermatic cord and gluteal region, suggesting wider anatomical distribution. We present a large series of LLT to further characterize its clinicopathologic and molecular features. Twenty-eight cases of LLT were retrieved from departmental and consult archives (including 8 from a prior series). The cohort comprised 28 patients (8 males, 20 females) with a median age of 28 years (range: 1-80 years). There were 17 primary LLT of the vulva. Other anatomical sites included the scrotum (n = 3), spermatic cord (n = 2), inguinal region (n = 2), limbs (n = 2), pelvis (n = 1), and retroperitoneum (n = 1). Median tumor size was 6.0 cm (range: 1.8-30.0 cm). The tumors had a lobulated architecture and were typically composed of adipocytes, lipoblasts, and spindle cells in a myxoid stroma with prominent thin-walled vessels. Using immunohistochemistry, a subset showed loss of Rb expression (12/23 of samples). Follow-up in 15 patients (median: 56 months) revealed 8 patients with local recurrence and 1 patient with metastases to the lung/pleura and breasts. Targeted DNA sequencing revealed a simple genomic profile with limited copy number alterations and low mutational burden. No alterations in RB1 were identified. The metastatic LLT showed concurrent pathogenic PIK3CA and MTOR activating mutations, both in the primary and in the lung/pleural metastasis; the latter also harbored TERT promoter mutation. One tumor had a pathogenic TSC1 mutation, and one tumor showed 2-copy deletion of CDKN2A, CDKN2B, and MTAP. No biologically significant variants were identified in 8 tumors. No gene fusions were identified by RNA sequencing in 4 tumors successfully sequenced. This study expands the clinicopathologic spectrum of LLT, highlighting its wider anatomical distribution and potential for occasional metastasis. Molecularly, we identified activating mutations in the PI3K-MTOR signaling pathway in 2 tumors, which may contribute to exceptional aggressive behavior.
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Affiliation(s)
- William J Anderson
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Adrian Mariño-Enríquez
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Marisa R Nucci
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Christopher D M Fletcher
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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5
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Gross JM, Perret R, Coindre JM, Le Loarer F, Michal M, Michal M, Miettinen M, McCabe CE, Nair AA, Swanson AA, Thangaiah JJ, Torres-Mora J, Bonadio A, Voltaggio L, Epstein JI, Gupta S, Folpe AL, Schoolmeester JK. Lipoblastoma-Like Tumor and Fibrosarcoma-Like Lipomatous Neoplasm Represent the Same Entity: A Clinicopathologic and Molecular Genetic Study of 23 Cases Occurring in Both Men and Women at Diverse Locations. Mod Pathol 2023; 36:100246. [PMID: 37307874 PMCID: PMC10530403 DOI: 10.1016/j.modpat.2023.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/14/2023]
Abstract
Lipoblastoma-like tumor (LLT) is a benign soft tissue tumor demonstrating mixed morphologic features of lipoblastoma, myxoid liposarcoma, and spindle cell lipoma but lacking genetic alterations associated with those tumors. LLT was originally thought to be specific to the vulva but has since been reported in the paratesticular region. The morphologic features of LLT overlap with those of "fibrosarcoma-like lipomatous neoplasm" (FLLN), a rare, indolent adipocytic neoplasm considered by some to form part of the spectrum of atypical spindle cell and pleomorphic lipomatous tumor. We compared the morphologic, immunohistochemical, and genetic features of 23 tumors previously classified as LLT (n = 17) and FLLN (n = 6). The 23 tumors occurred in 13 women and 10 men (mean age, 42 years; range, 17 to 80 years). Eighteen (78%) cases arose in the inguinogenital region, whereas 5 tumors (22%) involved noninguinogenital soft tissue, including the flank (n = 1), shoulder (n = 1), foot (n = 1), forearm (n = 1), and chest wall (n = 1). Microscopically, the tumors were lobulated and septated, with variably collagenized fibromyxoid stroma, prominent thin-walled vessels, scattered univacuolated or bivacuolated lipoblasts, and a minor component of mature adipose tissue. Using immunohistochemistry, 5 tumors (42%) showed complete RB1 loss, with partial loss in 7 cases (58%). RNA sequencing, chromosomal microarray, and DNA next-generation sequencing study results were negative for significant alterations. There were no clinical, morphologic, immunohistochemical, or molecular genetic differences between cases previously classified as LLT or FLLN. Clinical follow-up (11 patients [48%]; range, 2-276 months; mean, 48.2 months) showed all patients were alive without disease, and only one patient had experienced a single local recurrence. We conclude that LLT and FLLN represent the same entity, for which "LLT" seems most appropriate. LLT may occur in either sex and any superficial soft tissue location. Careful morphologic study and appropriate ancillary testing should allow for the distinction of LLT from its potential mimics.
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Affiliation(s)
- John M Gross
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Raul Perret
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France; Bordeaux Institute of Oncology, Université de Bordeaux, Institut Bergonié, Bordeaux, France
| | - Jean Michel Coindre
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France; Bordeaux Institute of Oncology, Université de Bordeaux, Institut Bergonié, Bordeaux, France; University of Bordeaux, Talence, France
| | - Francois Le Loarer
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France; Bordeaux Institute of Oncology, Université de Bordeaux, Institut Bergonié, Bordeaux, France; University of Bordeaux, Talence, France
| | - Michael Michal
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Michal Michal
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Markku Miettinen
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Chantal E McCabe
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, Minnesota
| | - Asha A Nair
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, Minnesota
| | - Amy A Swanson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Judith J Thangaiah
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Jorge Torres-Mora
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Angelo Bonadio
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lysandra Voltaggio
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jonathan I Epstein
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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Chia MRH, Windsor M. Metastatic lipoblastoma-like tumour. ANZ J Surg 2023; 93:689-691. [PMID: 35775445 DOI: 10.1111/ans.17884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/30/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Lipoblastoma-like tumours (LLT) are uncommon and their biologic nature is not well-understood. Complete resection of the primary lesion is usually curative. This is the first reported case of metastatic LLT. CASE PRESENTATION AND MANAGEMENT This patient originally had a large primary resected from the vulva. She subsequently developed tumours in multiple areas including her right pleura and lung. These were resected and pathology was consistent with LLT. On follow-up imaging, there was evidence of metastatic disease. CONCLUSION The patient is currently undergoing detailed molecular analysis in the hope of detecting a molecular target. Given the infrequent occurrence of LLT, its behaviour is not well understood. Longer duration of follow up is required and prognostic markers need to be identified to better direct treatment.
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Affiliation(s)
- Misté Rong Hui Chia
- Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Morgan Windsor
- Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia
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Croce S, Perret R, Le Loarer F. Update on Mesenchymal Lesions of the Lower Female Genital Tract. Surg Pathol Clin 2022; 15:341-367. [PMID: 35715165 DOI: 10.1016/j.path.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article provides an update of the recent developments in mesenchymal tumors of lower genital tract. We focus on the characterization of recurrent molecular events in certain genital stromal tumors, for instance angiomyofibroblastomas and superficial myofibroblastomas. Moreover, fusions involving Tyrosine-kinases receptors (NTRK, FRFR1, RET, COL1A1-PDGFB) have been demonstrated in an emerging group of mesenchymal tumors characterized by a fibrosarcoma-like morphology and a predilection for uterine cervix of premenopausal women. We also cover the topic of smooth muscle tumors of the lower genital tract, which can be now classified using the same diagnostic criteria than their uterine counterpart..
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Affiliation(s)
- Sabrina Croce
- Biopathology Department, Anticancer Center, Institut Bergonié, Bordeaux, France; INSERM U 1218, Action Unit, Bordeaux, France.
| | - Raul Perret
- Biopathology Department, Anticancer Center, Institut Bergonié, Bordeaux, France; INSERM U 1218, Action Unit, Bordeaux, France
| | - François Le Loarer
- Biopathology Department, Anticancer Center, Institut Bergonié, Bordeaux, France; INSERM U 1218, Action Unit, Bordeaux, France; University of Bordeaux, Talence, France
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Rastegar S, Aisner SC, Heller DS. Nonsquamous Lesions of the Vulvar Skin and Subcutaneous Tissue: A Review (Part 2). J Low Genit Tract Dis 2022; 26:156-163. [PMID: 35067584 DOI: 10.1097/lgt.0000000000000651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this second article was to complete part 1 review of nonsquamous lesions of the vulvar skin and subcutaneous tissue (Journal of Lower Genital Tract Disease, 2021), clinically and pathologically, based on the fifth edition of the World Health Organization tumor classification. MATERIALS AND METHODS A database search of PubMed and Google Scholar was performed between 1970 and 2021, using the search terms "vulva," "lower genital tract," and "non-squamous lesions." The search was limited to "human gynecological pathology." Full article texts were reviewed, and reference lists were screened for additional articles. We excluded abstracts and articles written in the non-English language. RESULTS An initial list of 400 articles was identified. Thirty-seven articles discussed clinicopathological features of nonsquamous lesions of the vulvar skin and subcutaneous tissue. CONCLUSIONS Clinicopathological features of nonsquamous lesions of the vulvar skin and subcutaneous tissue as categorized by the updated World Health Organization classification are presented.
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Affiliation(s)
- Shima Rastegar
- Department of Pathology, Immunology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ
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9
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Vásquez-Dongo C, Rivas A, Ferrer B, Bodet D, Valverde C, Delbene C, Ramón Y Cajal S, Romagosa C. [Lipoblastoma-like tumor of the vulva: A case report and review of the literature]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55:139-144. [PMID: 35483770 DOI: 10.1016/j.patol.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/02/2019] [Accepted: 10/17/2019] [Indexed: 06/14/2023]
Abstract
Lipoblastoma-like tumor of the vulva (LBLTV) was first described as a benign mesenchymal neoplasia; it was not recognized as a separate diagnosis in the 2013 WHO classification of soft-tissue tumors. To date, only 19 cases have been reported. LBLTV differential diagnosis includes other tumors of the vulvoperineal region and tumors with adipocytic differentiation, most of which are benign and thus a misdiagnosis has few clinical consequences. However, LBLTV may also mimic some aggressive lipomatous neoplasms. We describe a case of LBLTV in a 28 year-old woman and review the literature.
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Affiliation(s)
- Carmen Vásquez-Dongo
- Servicio de Anatomía Patológica, Hospital Universitario de Girona Dr. Josep Trueta, Girona, España; Universidad de Girona, Girona, España
| | - Antoni Rivas
- Servicio de Radiología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Berta Ferrer
- Servicio de Anatomía Patológica, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Domingo Bodet
- Servicio de Dermatología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Claudia Valverde
- Servicio de Oncología, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Clara Delbene
- Servicio de Anatomía Patológica, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - Santiago Ramón Y Cajal
- Servicio de Anatomía Patológica, Hospital Universitario Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Bellaterra, Barcelona, España
| | - Cleofé Romagosa
- Servicio de Anatomía Patológica, Hospital Universitario Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Bellaterra, Barcelona, España.
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10
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Yergin CG, Chang M, Thomas RM. When is a lipoma not a lipoma? Case report presenting a lipoblastoma-like tumor of the gluteal cleft in an older gentleman with literature review. Int J Surg Case Rep 2022; 92:106889. [PMID: 35245849 PMCID: PMC8892077 DOI: 10.1016/j.ijscr.2022.106889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction and importance Lipoblastoma-like tumors are rare tumors that can be confused with lipoblastomas and liposarcomas but have distinct characteristics. This tumor has previously been identified in the vulva of females, and recently in isolated cases of young males. Given its rarity, we present an instance of this tumor in an older man, demonstrating that this pathology is not limited to a specific age or sex, and surgeons and pathologists must be aware of it in their differential. Case presentation A 58-year-old male presented for evaluation of an enlarging mass in his right gluteal cleft. Prior to referral for surgical evaluation, the patient underwent an ultrasound-guided biopsy of the mass. Histologically, the tumor was a low-grade cellular spindle cell neoplasm in a fibrous to myxoid stroma. Immunohistochemical and molecular workup ruled out several malignant mesenchymal neoplasms, including myxoid liposarcoma, dedifferentiated liposarcoma, melanoma, low-grade fibromyxoid sarcoma, and sarcomatoid carcinoma. The patient initially declined surgery, but the mass continued to grow, and excision was chosen given the uncertain pathology. The tumor was resected with negative margins and histologically characterized as a “lipoblastoma-like lesion”, with features of a myxoid liposarcoma and spindle cell lipoma. Seven months post-resection, there were no signs of recurrence or metastasis. Clinical discussion Despite radiologic and pathologic similarities to malignant lipomatous tumors, lipoblastoma-like tumors are benign and have a good prognosis. Conclusions Clinicians should be aware of this entity despite its rarity as resection with negative margins is curative and may be needed to rule out more aggressive tumors. Lipoblastoma-like tumors (LLTs) are rare soft tissue tumors. LLTs can easily be confused clinically and pathologically for benign lipomas but also malignant liposarcomas. Pathologic evaluation is able to distinguish these tumors from their more aggressive counterparts. Because of their rare nature, clinicians may over or under-treat these tumors which require surgical excision. Local recurrence is rare but is predicated on negative surgical margins.
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11
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Thway K. What’s new in adipocytic neoplasia? Histopathology 2021; 80:76-97. [DOI: 10.1111/his.14548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Khin Thway
- Sarcoma Unit Royal Marsden Hospital London UK
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12
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Logan SJ, Schieffer KM, Conces MR, Stonerock E, Miller AR, Fitch J, LaHaye S, Voytovich K, McGrath S, Magrini V, White P, Wilson RK, Mardis ER, Cottrell CE, Koo SC. Novel morphologic findings in PLAG1-rearranged soft tissue tumors. Genes Chromosomes Cancer 2021; 60:577-585. [PMID: 33893698 DOI: 10.1002/gcc.22953] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 12/13/2022] Open
Abstract
Oncogenesis in PLAG1-rearranged tumors often results from PLAG1 transcription factor overexpression driven by promoter-swapping between constitutively expressed fusion partners. PLAG1-rearranged tumors demonstrate diverse morphologies. This study adds to this morphologic heterogeneity by introducing two tumors with PLAG1 rearrangements that display distinct histologic features. The first arose in the inguinal region of a 3-year-old, appeared well-circumscribed with a multinodular pattern, and harbored two fusions: ZFHX4-PLAG1 and CHCHD7-PLAG1. The second arose in the pelvic cavity of a 15-year-old girl, was extensively infiltrative and vascularized with an adipocytic component, and demonstrated a COL3A1-PLAG1 fusion. Both showed low-grade cytomorphology, scarce mitoses, no necrosis, and expression of CD34 and desmin. The ZFHX4-/CHCHD7-PLAG1-rearranged tumor showed no evidence of recurrence after 5 months. By contrast, the COL3A1-PLAG1-rearranged tumor quickly recurred following primary excision with positive margins; subsequent re-excision with adjuvant chemotherapy resulted in no evidence of recurrence after 2 years. While both tumors show overlap with benign and malignant fibroblastic and fibrovascular neoplasms, they also display divergent features. These cases highlight the importance of appropriate characterization in soft tissue tumors with unusual clinical and histologic characteristics.
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Affiliation(s)
- Suzanna J Logan
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kathleen M Schieffer
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Miriam R Conces
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Eileen Stonerock
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Anthony R Miller
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - James Fitch
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Stephanie LaHaye
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kyle Voytovich
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sean McGrath
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Vincent Magrini
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Peter White
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Richard K Wilson
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Elaine R Mardis
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Catherine E Cottrell
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pathology, The Ohio State University, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
| | - Selene C Koo
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pathology, The Ohio State University, Columbus, Ohio, USA
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13
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Gerhard-Hartmann E, Wiegering V, Benoit C, Meyer T, Rosenwald A, Maurus K, Ernestus K. A large retroperitoneal lipoblastoma as an incidental finding: a case report. BMC Pediatr 2021; 21:159. [PMID: 33814013 PMCID: PMC8019505 DOI: 10.1186/s12887-021-02628-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background Lipoblastoma is a rare benign mesenchymal neoplasm of infancy that most commonly occurs on the extremities and trunk but can arise at variable sites of the body. Retroperitoneal lipoblastomas are particularly rare but can grow to enormous size, and preoperative diagnosis is difficult with diverse, mostly malignant differential diagnoses that would lead to aggressive therapy. Since lipoblastoma is a benign tumor that has an excellent prognosis after resection, correct diagnosis is crucial. Case presentation A case of a large retroperitoneal tumor of a 24-month old infant that was clinically suspicious of a malignant tumor is presented. Due to proximity to the right kidney, clinically most probably a nephroblastoma or clear cell sarcoma of the kidney was suspected. Radiological findings were ambiguous. Therefore, the mass was biopsied, and histology revealed an adipocytic lesion. Although mostly composed of mature adipocytes, in view of the age of the patient, the differential diagnosis of a (maturing) lipoblastoma was raised, which was supported by molecular analysis demonstrating a HAS2-PLAG1 fusion. The tumor was completely resected, and further histopathological workup led to the final diagnosis of a 13 cm large retroperitoneal maturing lipoblastoma. The child recovered promptly from surgery and showed no evidence of recurrence so far. Conclusion Although rare, lipoblastoma should be included in the differential diagnoses of retroperitoneal tumors in infants and children, and molecular diagnostic approaches could be a helpful diagnostic adjunct in challenging cases.
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Affiliation(s)
- Elena Gerhard-Hartmann
- Department of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany. .,Comprehensive Cancer Center Mainfranken, Würzburg, Germany.
| | | | - Clemens Benoit
- Division of Pediatric Radiology, University Department of Radiology, Würzburg, Germany
| | - Thomas Meyer
- Division of Pediatric Surgery, University Medical Center ZOM, Würzburg, Germany
| | - Andreas Rosenwald
- Department of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Katja Maurus
- Department of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, Würzburg, Germany
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14
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Chapel DB, Cipriani NA, Bennett JA. Mesenchymal lesions of the vulva. Semin Diagn Pathol 2020; 38:85-98. [PMID: 32958293 DOI: 10.1053/j.semdp.2020.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 02/01/2023]
Abstract
Mesenchymal lesions of the vulva include site-specific entities limited to the lower genital tract, as well as a range of non-site-specific tumors that are more common at extragenital sites. Site-specific lesions include fibroepithelial stromal polyp, cellular angiofibroma, angiomyofibroblastoma, and aggressive angiomyxoma. Non-site-specific tumors that may occur in the vulva include those of smooth muscle, skeletal muscle, vascular, neural, adipocytic, and uncertain differentiation. This review discusses both site-specific and non-site-specific vulvar mesenchymal lesions including non-neoplastic proliferations, benign neoplasms, locally aggressive neoplasms with a predilection for local recurrence, neoplasms of indeterminate biologic potential, and frankly malignant neoplasms with a high risk of distant metastasis and death. Accurate diagnosis is essential for proper management, and is facilitated by correlation with clinical findings and targeted application of immunohistochemical and molecular studies.
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Affiliation(s)
- David B Chapel
- Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Nicole A Cipriani
- Department of Pathology, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Jennifer A Bennett
- Department of Pathology, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA.
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15
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Gambarotti M, Erdogan KE, Righi A, Benini S, Raspollini MR, Rose AD, Magagnoli G, Sbaraglia M, Dei Tos AP. Lipoblastoma-like tumor of the spermatic cord: case report and review of the literature. Virchows Arch 2020; 478:1013-1017. [PMID: 32617677 DOI: 10.1007/s00428-020-02883-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/05/2020] [Accepted: 06/22/2020] [Indexed: 10/23/2022]
Abstract
Lipoblastoma-like tumor is a very rare mesenchymal tumor believed to be restricted to female patients and only recently reported in the spermatic cord of a male patient. We describe herein an additional case of lipoblastoma-like tumor occurring in the spermatic cord, describing its histopathological, immunohistochemical, and molecular features.
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Affiliation(s)
- Marco Gambarotti
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Kivilcim E Erdogan
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Stefania Benini
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy.
| | | | | | - Giovanna Magagnoli
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy
| | - Angelo P Dei Tos
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, Italy.,Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy.,Department of Medicine, University of Padua School of Medicine, Padua, Italy
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16
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Droop E, Orosz Z, Michal M, Melegh Z. A lipoblastoma-like tumour of the paratesticular region - male counterpart of lipoblastoma-like tumour of the vulva. Histopathology 2020; 76:628-630. [PMID: 31622502 DOI: 10.1111/his.14020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Elizabeth Droop
- Cellular Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Zsolt Orosz
- Department of Histopathology, Nuffield Orthopaedic Centre, Oxford, UK
| | - Michael Michal
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic.,Biomedical Center, Faculty of Medicine in Plzen, Charles University, Plzen, Czech Republic.,Bioptical Laboratory, Ltd, Plzen, Czech Republic
| | - Zsombor Melegh
- Cellular Pathology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
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17
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Shi Y, Yang K, Zhang M, Yi C, Yu J. Lipoblastoma of the left kidney: a case report and review of literature. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:150. [PMID: 31157271 DOI: 10.21037/atm.2019.03.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A lipoblastoma is an infrequent benign tumor derived from embryonal adipose tissue. There are few reports on kidney lipoblastomas; there are fewer than three cases, including our case. An 80-year-old female was detected to have a left renal mass during a routine medical examination. Computed tomography (CT) and magnetic resonance imaging (MRI) indicated a heterogeneous mass before surgery, and histopathological tests subsequently revealed that the mass was a rare lipoblastoma. We present this case as a reminder to consider lipoblastomas in the differential diagnoses of kidney masses.
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Affiliation(s)
- Yangsheng Shi
- Department of Urology, The First People's Hospital of Yichang, China Three Gorges University, Yichang 443007, China
| | - Kang Yang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 443000, China
| | - Man Zhang
- Department of Urology, The First People's Hospital of Yichang, China Three Gorges University, Yichang 443007, China
| | - Cheng Yi
- Department of Urology, The First People's Hospital of Yichang, China Three Gorges University, Yichang 443007, China
| | - Junfeng Yu
- Department of Urology, The First People's Hospital of Yichang, China Three Gorges University, Yichang 443007, China
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18
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Abstract
Adipocytic neoplasms in the pediatric population demonstrate a different histologic spectrum and frequency than in adults. The vast majority of these tumors are benign, with lipoma being the most common entity. The identification of signature cytogenetic and molecular alterations for certain lesions, such as PLAG1 gene rearrangement in lipoblastoma and FUS-DDIT3 fusion in myxoid liposarcoma, has been helpful in approaching these neoplasms and aiding in confirming the diagnosis. Furthermore, it is important for pathologists to recognize that adipocytic neoplasms may be associated with different syndromes with potential impact in managing such patients. This review provides a summary of the clinical pictures, histologic characteristics, molecular alterations, differential diagnoses, and syndromic associations of the commonly encountered fatty tumors in children.
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Affiliation(s)
- Juan Putra
- Paediatric Pathologist, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Ave Rm. 3119, Toronto, ON M5G 1X8, Canada.
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Children's Hospital Boston and Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States.
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19
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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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20
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Goh GH, Putti TC, Ngo R, Agaimy A, Petersson F. Primary Pleomorphic Lipoma of the Parotid Gland with Prominent Myxoid Change: Report of a Rare Case Mimicking Carcinoma Ex Pleomorphic Adenoma on Fine Needle Aspiration Cytology. Head Neck Pathol 2019; 14:246-249. [PMID: 30610525 PMCID: PMC7021853 DOI: 10.1007/s12105-018-00998-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 12/29/2018] [Indexed: 11/25/2022]
Abstract
We present a case of a primary 2.5 cm pleomorphic lipoma of the right parotid gland with prominent myxoid change which on FNA displayed features that mimicked a carcinoma or sarcoma ex pleomorphic adenoma. The patient was a 79 year old man with no oncological history or tumor elsewhere. On immunohistochemistry the neoplastic cells strongly expressed CD34. There was no expression of retinoblastoma protein, smooth muscle actin, S100-protein or cytokeratins (AE1/3 and CAM5.2). The Ki-67 proliferation index was low (< 2%). Fluorescence in situ hybridization was negative for MDM2 gene amplification.
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Affiliation(s)
- Giap Hean Goh
- Department of Pathology, National University Hospital, Singapore, Singapore
| | | | - Raymond Ngo
- Department of Otolaryngology - Head and Neck Surgery (ENT), National University Hospital, Singapore, Singapore
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich Alexander University (FAU), Erlangen, Germany
| | - Fredrik Petersson
- Department of Pathology, National University Hospital, Singapore, Singapore.
- Department of Pathology, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
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