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Zhang KB, Xu JF, Feng JG, Wang DL. Chondroid lipoma recurrence and malignant transformation in the proximal popliteal fossa: A case report. Asian J Surg 2023; 46:4807-4808. [PMID: 37277280 DOI: 10.1016/j.asjsur.2023.05.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/19/2023] [Indexed: 06/07/2023] Open
Affiliation(s)
- Kai-Bo Zhang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, 050011, Hebei Province, China
| | - Jian-Fa Xu
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, 050011, Hebei Province, China
| | - Jian-Gang Feng
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, 050011, Hebei Province, China
| | - Dong-Lai Wang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, 12 Health Road, Shijiazhuang, 050011, Hebei Province, China.
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2
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Sugiyama K, Washimi K, Sato S, Hiruma T, Sakai M, Okubo Y, Miyagi Y, Yokose T. Differential diagnosis of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma by cytological analysis. Diagn Cytopathol 2022; 50:112-122. [PMID: 34984861 PMCID: PMC9305447 DOI: 10.1002/dc.24928] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adipocytic tumors are the most common soft tissue tumors, with lipomas and atypical lipomatous tumor/well-differentiated liposarcomas (ALT/WDL), which comprise most cases. Preoperative differential diagnosis of lipoma or ALT/WDL can provide important information for decisions regarding treatment. We evaluated the cytological findings of 20 cases of lipoma and ALT/WDL. METHODS Fluorescence in situ hybridization (FISH) was performed on formalin-fixed paraffin-embedded specimens (FFPE) to examine mouse double minute 2 homolog (MDM2) amplification in all cases. Tissue samples were collected from the center of the surgical materials, stained with Pap, and evaluated for 12 cytological parameters by six cytotechnologists. RESULTS The findings regarding large atypical cells, multinucleated cells, and nuclear pleomorphism were highly concordant among the cytotechnologists and were associated with MDM2 amplification. Large atypical cells, considered a highly specific feature of ALT/WDL, were not observed in lipoma cases. However, the sensitivity of the large atypical cell findings was not high (67%); therefore, comprehensive evaluation of multinucleated cells and pleomorphism is crucial for predicting ALT/WDL diagnosis. FISH of MDM2 on Pap-stained specimens was performed in four cases. In two, the results were similar to those of MDM2 FISH performed on FFPE sections and were reproducible, whereas in the other two, the signal could not be evaluated because of the strong background coloration. CONCLUSIONS Cytology specimens may be useful for the preoperative diagnosis of adipocytic tumors, particularly if the FISH conditions for Pap-stained specimens and the detection accuracy of MDM2 amplification can be improved.
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Affiliation(s)
- Kana Sugiyama
- Department of Clinical Laboratory, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Kota Washimi
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Shinya Sato
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
| | - Toru Hiruma
- Department of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Mai Sakai
- Department of Clinical Laboratory, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yoichiro Okubo
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
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Tannenbaum M, Colucci PG, Baad M, Borczuk AC, Steigman SA, Kovanlikaya A. Chondroid lipoma: multimodality imaging in a 9-year-old female. Skeletal Radiol 2020; 49:161-169. [PMID: 31230114 DOI: 10.1007/s00256-019-03259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 02/02/2023]
Abstract
Chondroid lipomas are rare, benign lipomatous tumors that occur most frequently in adults during the fourth decade of life. While a female predominance was observed in the initial series of 20 cases described in 1993, the subsequent 49 reported cases do not support a strong gender predilection. We report a case of a chondroid lipoma presenting in a 9-year-old female as a painless, enlarging, left gluteal mass. This is the second case to be reported in the first decade of life and the fourth pediatric case reported in the literature (age < 21). We review the imaging and pathology findings as well as present a comprehensive review of the current literature.
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Affiliation(s)
- Melissa Tannenbaum
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA
| | - Philip G Colucci
- New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Radiology, 525 East 68th Street, New York, NY, 10065, USA
| | - Michael Baad
- New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Radiology, 525 East 68th Street, New York, NY, 10065, USA
| | - Alain C Borczuk
- New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Pathology, 525 East 68th Street, New York, NY, 10065, USA
| | - Shaun A Steigman
- New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Surgery, 525 East 68th Street, New York, NY, 10065, USA
| | - Arzu Kovanlikaya
- New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Radiology, 525 East 68th Street, New York, NY, 10065, USA.
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Abstract
RATIONALE Chondroid lipoma (CL) is a rare benign tumor. No relevant epidemiological reports have been published on CL, and there is a lack of uniform diagnostic and treatment criteria for the tumor. PATIENT CONCERNS Here, we report a case of CL with a mass on the left buttock for 2 weeks, and further illuminate its diagnosis and treatment. DIAGNOSIS The diagnosis of CL was rendered according to the pathological indices. INTERVENTIONS The tumor was resected completely under spinal anesthesia. OUTCOMES The patient was followed-up for 6 months and showed no tumor recurrence or metastasis and there was resolution of the patient's lower-limb numbness and pain. LESSONS The case study presented here provides evidence that CL could be effectively diagnosed by using ultrasound, puncture or biopsy, and/or magnetic resonance imaging. Furthermore, the patient recovered without any complications after completely resecting the tumor.
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5
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Fine-needle aspiration of lipoblastoma: Cytological, molecular, and clinical features. Cancer Cytopathol 2017; 125:934-939. [DOI: 10.1002/cncy.21916] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/21/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
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6
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Yıldız AE, Aydıngöz Ü, Sökmensüer C, Karçaaltıncaba M. Intramuscular chondroid lipoma: magnetic resonance imaging diagnosis by 'fat ring sign'. Balkan Med J 2015; 32:107-10. [PMID: 25759781 DOI: 10.5152/balkanmedj.2014.14035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 08/12/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Chondroid lipoma is an extremely rare variant of benign lipomatous lesions that is composed of lipoblasts, mature fat, and chondroid matrix. Although benign lipomatous lesions are the most common soft tissue tumors and imaging findings are often pathognomonic, there have been few reports describing the imaging features of chondroid lipoma. CASE REPORT We present magnetic resonance imaging (MRI) findings of a pelvic intramuscular chondroid lipoma in a 59 year-old man and describe a "fat ring sign" that may be useful to diagnose this rare tumor radiologically. CONCLUSION Magnetic resonance imaging findings of a chondroid lipoma may be heterogenous according to the distribution of the fatty and chondroid tissue. However, in the presence of "fat ring sign," radiologists should consider a diagnosis of chondroid lipoma preoperatively.
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Affiliation(s)
- Adalet Elçin Yıldız
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Üstün Aydıngöz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cenk Sökmensüer
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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7
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Setiawati R, Dimpudus FJ, Sun Z. Chondroid lipoma of the right thigh: Correlation of imaging findings and histopathology of an unusual benign lesion. Australas Med J 2012; 5:355-8. [PMID: 22905062 DOI: 10.4066/amj.2012.1260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Chondroid lipoma is a rare and unusual benign soft tissue lesion. Although there have been several reports of the imaging findings of chondroid lipoma, very few described the radiographic calcification or ossification in a chondroid lipoma. We present a case of chondroid lipoma with adipose tissue and ossified components on plain radiography and MRI images. Correlation of imaging findings and pathological examination is provided to confirm the diagnosis.
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Affiliation(s)
- Rosy Setiawati
- Musculoskeletal Division, Department of Radiodiagnostic, Faculty of Medicine Airlangga University, Indonesia
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8
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Gandhi A, Mahajan G, Sharma S. Chondroid lipoma mimicking pleomorphic adenoma on cytology. Diagn Cytopathol 2012; 41:1012-3. [PMID: 22711496 DOI: 10.1002/dc.22880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 04/24/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Akansha Gandhi
- Department of Pathology, University College of Medical Sciences, Guru Teg Bahadur Hospital, Shahdara, Delhi, India
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Ananthamurthy A, Nisheena R, Rao B, Correa M. Extraskeletal myxoid chondrosarcoma: Diagnosis of a rare soft tissue tumor based on fine needle aspiration cytology. J Cytol 2011; 26:36-8. [PMID: 21938148 PMCID: PMC3167989 DOI: 10.4103/0970-9371.54867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma with limited literature available on its cytological features. We report here one such case where a diagnosis of EMC was made based on fine needle aspiration cytology (FNAC). A 51 year-old male presented to our FNAC clinic with a slowly growing mass in the left thigh, which was subjected to fine needle aspiration biopsy. Radiological images showed no involvement of the underlying bone. Magnetic resonance imaging was suggestive of a malignant neoplasm. The FNA smears showed cell fragments and cords of monotonous cells embedded in abundant myxoid stroma. A diagnosis of a myxoid sarcoma favoring an EMC was made in this patient. Subsequent excision of the mass for histopathological examination confirmed this diagnosis. EMC has distinctive cytological features that are helpful in confidently making a diagnosis in the appropriate clinical setting.
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10
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Dodd LG. Update on Liposarcoma: A review for cytopathologists. Diagn Cytopathol 2011; 40:1122-31. [DOI: 10.1002/dc.21794] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 07/07/2011] [Indexed: 11/10/2022]
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Rosa M, Bajestani S, Davis C, Makary R, Villas B. Fine-needle aspiration biopsy diagnosis of costal juxtacortical chondrosarcoma presenting as an abdominal mass. Diagn Cytopathol 2010; 38:837-40. [DOI: 10.1002/dc.21339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Hoch B, Hermann G, Klein MJ, Abdelwahab IF. Ossifying chondroid lipoma. Skeletal Radiol 2008; 37:475-80. [PMID: 18259746 DOI: 10.1007/s00256-007-0444-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Revised: 12/05/2007] [Accepted: 12/08/2007] [Indexed: 02/02/2023]
Abstract
Chondroid lipoma is a rare variant of lipoma that pathologically can mimic liposarcoma or possibly other sarcomas. Variants of lipoma, including chondroid lipoma, may demonstrate radiological evidence of fat within the tumor, but often display heterogeneous features on imaging studies, making a clinical diagnosis difficult. A large collective experience with the imaging characteristics of chondroid lipoma is lacking due to the rarity of this tumor. We present a case of chondroid lipoma of the upper thigh in a 37-year-old woman who had regions of metaplastic bone formation within the tumor. Radiologically, the tumor presented as a large soft tissue mass with calcification and ossification. Although metaplastic bone formation in conventional lipoma is well described, it has been rarely reported to occur in chondroid lipoma and has not been pathologically documented or illustrated. The imaging findings and histopathology of this unusual tumor are presented, along with a review of the literature.
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Affiliation(s)
- Benjamin Hoch
- Department of Pathology, Mount Sinai Medical Center, P.O. Box 1194, One Gastave L. Levy Place, New York, NY 07422, USA.
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14
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Hernández Gonzalo D, Salinas-Martín MV, Carranza-Carranza A, Gavilán-Carrasco F. [Chondroid lipoma:a rare lesion posing diagnostic difficulties]. Cir Esp 2007; 82:315-6. [PMID: 18021639 DOI: 10.1016/s0009-739x(07)71738-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Bancroft LW, Kransdorf MJ, Peterson JJ, O'Connor MI. Benign fatty tumors: classification, clinical course, imaging appearance, and treatment. Skeletal Radiol 2006; 35:719-33. [PMID: 16927086 DOI: 10.1007/s00256-006-0189-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2004] [Revised: 07/06/2004] [Accepted: 07/08/2006] [Indexed: 02/07/2023]
Abstract
Lipoma is the most common soft-tissue tumor, with a wide spectrum of clinical presentations and imaging appearances. Several subtypes are described, ranging from lesions entirely composed of mature adipose tissue to tumors intimately associated with nonadipose tissue, to those composed of brown fat. The imaging appearance of these fatty masses is frequently sufficiently characteristic to allow a specific diagnosis. However, in other cases, although a specific diagnosis is not achievable, a meaningful limited differential diagnosis can be established. The purpose of this manuscript is to review the spectrum of benign fatty tumors highlighting the current classification system, clinical presentation and behavior, spectrum of imaging appearances, and treatment. The imaging review emphasizes computed tomography (CT) scanning and magnetic resonance (MR) imaging, differentiating radiologic features.
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Affiliation(s)
- Laura W Bancroft
- Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224-3899, USA
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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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Green RAR, Cannon SR, Flanagan AM. Chondroid lipoma: correlation of imaging findings and histopathology of an unusual benign lesion. Skeletal Radiol 2004; 33:670-3. [PMID: 15351916 DOI: 10.1007/s00256-004-0818-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2004] [Revised: 05/19/2004] [Accepted: 05/25/2004] [Indexed: 02/02/2023]
Abstract
The imaging findings of soft tissue tumours are often non-specific and generally require biopsy to differentiate between benign and malignant lesions. The finding of curvilinear, annular or amorphous mineralisation in an enlarging mass has sinister connotations. In this case report, we present the imaging findings with histological correlation of a chondroid lipoma, an unusual benign soft tissue tumour, which presented with radiographic evidence of calcification, an imaging finding not previously described. We also describe the ultrasound appearance and certain MR imaging appearances that have not been previously attributed to this tumour in the few reported cases.
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Affiliation(s)
- R A R Green
- Department of Radiology, The Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
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18
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Sandberg AA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors: lipoma. ACTA ACUST UNITED AC 2004; 150:93-115. [PMID: 15066317 DOI: 10.1016/j.cancergencyto.2003.12.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2003] [Revised: 12/22/2003] [Accepted: 12/24/2003] [Indexed: 02/02/2023]
Affiliation(s)
- Avery A Sandberg
- Department of DNA Diagnostics, St. Joseph's Hospital and Medical Center, 350 West Thomas Road, Phoenix, AZ 85013, USA.
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Boltze C, Hribaschek A, Lippert H, Roessner A. Intermuscular chondrolipoma of the thigh: the diagnostic way of a rare entity. Pathol Res Pract 2004; 199:503-7. [PMID: 14521269 DOI: 10.1078/0344-0338-00454] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cartilaginous metaplasia in lipomas (chondrolipoma) is rare and mainly encountered in large-sized, long-standing lipomas. Chondrolipomas can be found at almost any site of the body, particularly in the connecting tissue of the skeletal system, breast, pharynx, and nasopharynx. We report on an intermuscular tumor of the thigh in a patient who suffered from lipomatosis in his past medical history. We describe how the diagnosis of chondrolipoma was reached and discuss the differential diagnoses.
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Affiliation(s)
- Carsten Boltze
- Department of Pathology, Otto-von-Guericke-University, Magdeburg, Germany.
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Jiménez-Heffernan JA, González-Peramato P, Perna C. Diagnosis of chondroid lipoma by fine-needle aspiration biopsy. Arch Pathol Lab Med 2002; 126:773; author reply 773-4. [PMID: 12125645 DOI: 10.5858/2002-126-773a-doclbf] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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In Reply. Arch Pathol Lab Med 2002. [DOI: 10.5858/2002-126-773b-ir] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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