Difference between revisions of "Adipocytic tumours"
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*[http://en.wikipedia.org/wiki/File:Hibernoma1.jpg Hibernoma (WC)]. | *[http://en.wikipedia.org/wiki/File:Hibernoma1.jpg Hibernoma (WC)]. | ||
==Atypical lipomatous tumour== | |||
*[[AKA]] ''well-differentiated liposarcoma'', abbreviated ''WDLPS''. | |||
*Abbreviated ''ALT/WDLPS''. | |||
===General=== | |||
*This is a [[waffle diagnosis]] - like [[ASCUS]]. | |||
===Microscopic=== | |||
Features:<ref>{{Ref WMSP|605}}</ref> | |||
*Large adipocytes. | |||
*Atypical lipoblasts - focal, scattered: | |||
**Nuclear hyperchromasia. | |||
**+/-Multinucleated. | |||
==Liposarcoma== | ==Liposarcoma== | ||
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*[http://commons.wikimedia.org/wiki/File:Myxoid_liposarcoma_%2805%29.JPG Myxoid liposarcoma (WC)]. | *[http://commons.wikimedia.org/wiki/File:Myxoid_liposarcoma_%2805%29.JPG Myxoid liposarcoma (WC)]. | ||
*[http://www.john-libbey-eurotext.fr/e-docs/00/04/09/14/texte_alt_jleejd00046_gr5.jpg Lipoblasts (john-libbey-eurotext.fr)]. | *[http://www.john-libbey-eurotext.fr/e-docs/00/04/09/14/texte_alt_jleejd00046_gr5.jpg Lipoblasts (john-libbey-eurotext.fr)]. | ||
====Subtypes==== | |||
There are several subtypes:<ref name=Ref_WMSP_601>{{Ref WMSP|601}}</ref> | |||
*Dedifferentiated liposarcoma. | |||
*Myxoid liposarcoma. | |||
*Mixed-type liposarcoma. | |||
*Pleomorphic liposarcoma. | |||
*Liposarcoma not otherwise specified (NOS). | |||
===IHC=== | ===IHC=== | ||
Revision as of 14:51, 4 April 2011
Adipocytic tumours fall into the grouping soft tissue lesions and includes things that are very common (e.g. lipoma) and everything from benign to malignant.
Lipoma
General
- Benign.
- Several variants exist.
- Angiolipoma - one of the (classically) painful skin lesions.
Microscopic
Features:
- Collection of mature adipocytes.
- Variation of size may be seen -- should prompt a search for lipoblasts.[1]
Notes:
- Microscopically not definitely distinguishable from mature clump of fat.
- The lesion must be labeled lipoma to be signed-out as such.
Pleomorphic lipoma
General
- ???
Microscopic
Features:
- Multinucleated cells - "floret cells".
- Very ugly looking cells.
- Fibrous septa.
Image: Floret cells in a pleomorphic lipooma (pathconsultddx.com).[2]
Notes:
- May overlap with spindle cell lipoma.[3]
Hibernoma
General
- Consists of brown fat (present in the infants to generate heat).[4]
- Benign.
- Usually asymptomatic.[5]
Epidemiology
- Young adults.
Gross
- Well-circumscribed.
- Lobulated and light-brown on sectioning.
Microscopic
Features:[6]
- Large polygonal/oval cells:
Image:
Atypical lipomatous tumour
- AKA well-differentiated liposarcoma, abbreviated WDLPS.
- Abbreviated ALT/WDLPS.
General
- This is a waffle diagnosis - like ASCUS.
Microscopic
Features:[9]
- Large adipocytes.
- Atypical lipoblasts - focal, scattered:
- Nuclear hyperchromasia.
- +/-Multinucleated.
Liposarcoma
- Most common malignant sarcoma in the retroperitoneum.
Microscopy
Features:
- Lipoblasts:
- Large sharply demarcated vacuole.
- Nucleus:
- Hyperchromatic (dark staining) nucleus.
- Eccentric location.
- Nuclear indentation.
Images:
Subtypes
There are several subtypes:[10]
- Dedifferentiated liposarcoma.
- Myxoid liposarcoma.
- Mixed-type liposarcoma.
- Pleomorphic liposarcoma.
- Liposarcoma not otherwise specified (NOS).
IHC
- IHC is of limited value.
- S-100 +ve ~1/3 of the time.
- Reticulin ???.
See also
References
- ↑ PMID 8548119.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970321-7. Accessed on: 4 December 2010.
- ↑ URL: http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/. Accessed on: 4 December 2010.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 605. ISBN 978-0781765275.
- ↑ Ahmed SA, Schuller I (December 2008). "Pediatric hibernoma: a case review". J. Pediatr. Hematol. Oncol. 30 (12): 900–1. doi:10.1097/MPH.0b013e318184e6dd. PMID 19131775.
- ↑ Chen DY, Wang CM, Chan HL (March 1998). "Hibernoma. Case report and literature review". Dermatol Surg 24 (3): 393–5. PMID 9537018.
- ↑ http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70271-6
- ↑ http://surgpathcriteria.stanford.edu/softfat/hibernoma/
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 605. ISBN 978-0781765275.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 601. ISBN 978-0781765275.