Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.891
Filtrar
1.
Int J Mol Sci ; 25(5)2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38473790

RESUMO

Adrenal myelolipomas (AML) are composed of mature adipose and hematopoietic components. They represent approximately 3 percent of adrenal tumors and are commonly found in patients with congenital adrenal hyperplasia (CAH). CAH provides a unique environment to explore AML pathogenesis. We aimed to evaluate the role of the immune system and hormones that accumulate in poorly controlled CAH in the development of AML. When compared to normal adrenal tissue, CAH-affected adrenal tissue and myelolipomas showed an increased expression of inflammatory cells (CD68, IL2Rbeta), stem cells (CD117) B cells (IRF4), and adipogenic markers (aP2/FABP4, AdipoQ, PPARγ, Leptin, CideA), and immunostaining showed nodular lymphocytic accumulation. Immunohistochemistry staining revealed a higher density of inflammatory cells (CD20, CD3, CD68) in CAH compared to non-CAH myelolipomas. In vitro RNA-sequencing studies using NCI-H295R adrenocortical cells with exogenous exposure to ACTH, testosterone, and 17-hydroxyprogesterone hormones, showed the differential expression of genes involved in cell cycle progression, phosphorylation, and tumorigenesis. Migration of B-lymphocytes was initiated after the hormonal treatment of adrenocortical cells using the Boyden chamber chemotaxis assay, indicating a possible hormonal influence on triggering inflammation and the development of myelolipomas. These findings demonstrate the important role of inflammation and the hormonal milieu in the development of AML in CAH.


Assuntos
Neoplasias das Glândulas Suprarrenais , Hiperplasia Suprarrenal Congênita , Leucemia Mieloide Aguda , Lipoma , Mielolipoma , Humanos , Mielolipoma/patologia , Neoplasias das Glândulas Suprarrenais/genética
2.
Kyobu Geka ; 77(3): 230-234, 2024 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-38465498

RESUMO

A 61-year-old woman was referred for further evaluation of an intracystic nodule in her left upper lung. Computed tomography( CT) showed a 15 mm nodule in a pulmonary cyst adjacent to aortic arch and mediastinum. Fluorodeoxyglucose-positron emission tomography (FDG-PET)-CT showed little uptake of FDG in the lesion. No abnormality was found in the bronchoscopy findings. On imaging findings, the possibility of pulmonary aspergilloma was considered, but the serological findings were inconsistent, and surgical resection of the lesion was performed for both diagnosis and treatment. The final pathohistological diagnosis was well differentiated liposarcoma. No adjuvant therapy was performed and the patient has been well without recurrence for 2 years after the surgery. We report a rare case of well differentiated liposarcoma of a lung mimicking pulmonary aspergilloma.


Assuntos
Lipoma , Lipossarcoma , Aspergilose Pulmonar , Humanos , Feminino , Pessoa de Meia-Idade , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons , Pulmão , Tomografia Computadorizada por Raios X , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia
3.
BMJ Case Rep ; 17(3)2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38508597

RESUMO

A man in his 40s presented with an incidental finding of an osteolytic bone lesion. He sustained an ankle injury while inline skating, fracturing his lateral malleolus. Besides the fracture, radiographic imaging on the day of the injury incidentally revealed a well-defined solitary osteolytic lesion with a sclerotic rim within the right calcaneus. MRI showed an intraosseous, fat-containing lesion with focal contrast enhancement, assessed as an intraosseous lipoma with central necrosis. In the pathological analysis of a sample of the lesion an intraosseous myolipoma of the calcaneus was found-an unexpected and extraordinary finding. To prevent pathological fracturing, curettage and bone grafting were performed using autologous iliac crest bone in combination with allogenous bone chips.


Assuntos
Neoplasias Ósseas , Calcâneo , Lipoma , Masculino , Humanos , Calcâneo/diagnóstico por imagem , Calcâneo/cirurgia , Calcâneo/patologia , Extremidade Inferior/patologia , Imageamento por Ressonância Magnética , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia , Lipoma/diagnóstico por imagem , Lipoma/cirurgia
4.
Ugeskr Laeger ; 186(5)2024 Jan 29.
Artigo em Dinamarquês | MEDLINE | ID: mdl-38327198

RESUMO

This case report presents a 69-year-old male patient with a subcutaneous tumour in the left parietal region. Initially, the tumour was identified as a lipoma or benign cyst by the general practitioner. However, a subsequent MRI scan revealed a sarcoma metastasis with a significant intracranial component. Radical excision of the tumour was not possible due to its critical localisation. Therefore, the patient received palliative radiotherapy. This case emphasises the importance of accurate clinical assessment and highlights the clinical features that should lead to suspicion of malignancy.


Assuntos
Cistos , Lipoma , Sarcoma , Neoplasias de Tecidos Moles , Masculino , Humanos , Idoso , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Imageamento por Ressonância Magnética
5.
J Med Case Rep ; 18(1): 75, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38403624

RESUMO

INTRODUCTION: Calcific tendinosis is a common condition caused by the deposition of hydroxyapatite crystals within the tendons that can impact any tendinous insertion. In this situation, ultrasound (US) may be a viable imaging modality in addition to radiography. CASE PRESENTATION: A 56-year-old Iranian male presented with left elbow pain. US evaluation at the lump site revealed a subcutaneous lipoma. Ultrasonography showed a thickened and diffusely heterogeneously hypoechoic pronator teres tendon. These characteristics were consistent with the diagnosis of calcific tendinosis. DISCUSSION AND CONCLUSION: Radiography is the most common and practical imaging modality for calcific tendinosis diagnosis. Despite this, the real-time nature of ultrasonography makes it both diagnostic and therapeutic in this condition. Other conditions, such as lipoma, may interfere with the proper diagnosis of calcific tendinosis.


Assuntos
Lipoma , Tendinopatia , Humanos , Masculino , Pessoa de Meia-Idade , Cotovelo/diagnóstico por imagem , Irã (Geográfico) , Ultrassonografia , Tendinopatia/diagnóstico por imagem , Tendinopatia/etiologia , Tendinopatia/terapia
6.
J Clin Neurosci ; 121: 119-128, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38394955

RESUMO

BACKGROUND: Total/near-total resection (TR/NTR) of complex lumbosacral lipomas (CSL) is reported to be associated with better long-term functional outcomes and lower symptomatic re-tethering rates. We report our institutional experience for CSL resection in affected children. METHODS: This is a single-institution, retrospective study. Inclusion criteria consist of patients with CSL with dorsal, transitional and chaotic lipomas based on Pang et al's classification. The study population is divided into 2 groups: asymptomatic patients with a normal preoperative workup referred to as 'prophylactic intent' and 'therapeutic intent' for those with pre-existing neuro-urological symptoms. Primary aims are to review factors that affect post-operative clean intermittent catheterization (CIC), functional outcomes based on Necker functional score (NFS), and re-tethering rates. RESULTS: 122 patients were included from 2000 to 2021. There were 32 dorsal lipomas (26.2 %), 74 transitional lipomas (60.7 %), and 16 chaotic lipomas (13.1 %). 82 % patients achieved TR/NTR. Favourable NFS at 1-year was 48.2 %. The re-tethering rate was 6.6 %. After multivariable analysis, post-operative CIC was associated with median age at surgery (p = 0.026), lipoma type (p = 0.029), conus height (p = 0.048) and prophylactic intent (p < 0.001). Next, extent of lipoma resection (p = 0.012) and the post-operative CSF leak (p = 0.004) were associated with re-tethering. Favourable NFS was associated with lipoma type (p = 0.047) and prophylactic intent surgery (p < 0.001). CONCLUSIONS: Our experience shows that TR/NTR for CSL is a feasible option to prevent functional deterioration and re-tethering. Efforts are needed to work on factors associated with post-operative CIC.


Assuntos
Lipoma , Neoplasias da Medula Espinal , Criança , Humanos , Lactente , Estudos Longitudinais , Estudos Retrospectivos , Resultado do Tratamento , Singapura/epidemiologia , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/cirurgia , Medula Espinal , Lipoma/cirurgia , Hospitais , Região Lombossacral/cirurgia
7.
Diagn Pathol ; 19(1): 40, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38388450

RESUMO

Fat-forming solitary fibrous tumor is a rare and specific subtype of solitary fibrous tumor. In this case, a mass of 8.3 cm in diameter was found in a 59-year-old male patient's right retroperitoneum, as revealed by abdominal contrast-enhanced computed tomography (CT) images. The tumor exhibited a well-circumscribed nature and histological features characterized by a combination of hemangiopericytomatous vasculature and mature adipose tissue, comprising around 70% of the total tumor composition. Immunohistochemistry staining revealed diffuse positive expression of STAT6 and CD34 in the tumor cells. Based on these findings, the final diagnosis was determined to be a fat-forming solitary fibrous tumor located in the retroperitoneum. It is important to consider other potential differential diagnoses, including angiomyolipoma, dedifferentiated liposarcoma, spindle cell lipoma, and atypical lipomatous tumor/well-differentiated liposarcoma.


Assuntos
Lipoma , Lipossarcoma , Tumores Fibrosos Solitários , Humanos , Masculino , Pessoa de Meia-Idade , Tecido Adiposo/metabolismo , Lipoma/diagnóstico , Lipoma/genética , Lipossarcoma/genética , Lipossarcoma/patologia , Tumores Fibrosos Solitários/diagnóstico , Tumores Fibrosos Solitários/genética , Tumores Fibrosos Solitários/patologia , Tomografia Computadorizada por Raios X
8.
Hum Pathol ; 145: 56-62, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38401716

RESUMO

Several high-grade pleomorphic sarcoma cases that cannot be classified into any existing established categories have been reported. These cases were provisionally classified into undifferentiated pleomorphic sarcoma (UPS). Some dedifferentiated liposarcoma (DDLS) cases may also have been classified into the UPS category due to the absence of MDM2 amplification or an atypical lipomatous tumor/well-differentiated liposarcoma component. We retrieved and reviewed 77 high-grade pleomorphic sarcoma cases, initially diagnosed as UPS in 66 cases and DDLS in 11 cases. Fluorescence in situ hybridization (FISH) analyses of DDIT3 and MDM2 were performed for available cases. Of the cases successfully subjected to DDIT3 FISH (n = 56), nine (7 UPS and 2 DDLS) showed DDIT3 amplification but no MDM2 amplification. Two UPS cases showed both telomeric (5') and centromeric (3') amplification of DDIT3 or low polysomy of chromosome 12, whereas 5 UPS and 2 DDLS cases showed 5'-predominant DDIT3 amplification. Histopathologically, all cases showed UPS-like proliferation of atypical pleomorphic tumor cells. Immunohistochemically, only one case showed focal nuclear positivity for DDIT3, supporting the previous finding that DDIT3 expression was not correlated with DDIT3 amplification. All three cases with focal MDM2 expression involved 5'-predominant amplification, two of which showed DDLS-like histological features. The majority of cases (7/9) showed decreased expression in p53 staining, suggesting that DDIT3 amplification regulates the expression of TP53 like MDM2. From a clinicopathological perspective, we hypothesize that DDIT3-amplified sarcoma, especially with 5'-predominant amplification, can be reclassified out of the UPS category.


Assuntos
Histiocitoma Fibroso Maligno , Lipoma , Lipossarcoma , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Lipossarcoma/patologia , Hibridização in Situ Fluorescente , Amplificação de Genes , Sarcoma/genética , Sarcoma/patologia , Lipoma/diagnóstico , Aberrações Cromossômicas , Neoplasias de Tecidos Moles/diagnóstico , Fator de Transcrição CHOP/genética , Fator de Transcrição CHOP/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/análise
9.
Hum Pathol ; 145: 63-70, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38423223

RESUMO

INTRODUCTION: Dedifferentiation occurs in approximately 10% of atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLPS), primarily in retroperitoneal or deep-seated tumors, conferring metastatic potential. Superficial dedifferentiated liposarcoma (sDDLPS) is rare, and its progression and natural history are poorly documented. METHODS: We performed a 15-year retrospective review of our pathology database to identify cases of DDLPS in the skin or subcutaneous tissue. Diagnosis of primary sDDLPS required evidence of non-lipogenic sarcoma in the skin or subcutis, with concurrent ALT/WDLPS and/or MDM2 amplification. RESULTS: We identified 14 cases of DDLPS involving skin or subcutis: 7 primary sDDLPS and 7 secondary lesions (3 from recurrent deep DDLPS and 4 from metastasis). Primary sDDLPS cases (4 females, 3 males; median age: 74) mainly presented as undifferentiated spindle cell or pleomorphic sarcoma. Tumor grades were grade 2 (5 cases) and grade 3 (2 cases), with three cases also showing grade 1 areas. MDM2 amplification was confirmed in 6 sDDLPSs for which FISH was successfully performed. Follow-up available for 6 sDDLPS patients showed 2 local recurrences, treated with re-excision and radiation therapy, with all disease-free at last follow-up (5-126 months). Of the 7 secondary cases, 2 had ongoing disease after multiple recurrences, 1 was disease-free, and all 4 with cutaneous metastasis died of disease (follow-up range: 24-263 months). CONCLUSION: These findings emphasize the importance of distinguishing between primary sDDLPS and secondary lesions due to their distinct prognoses. Metastasis or superficial extensions from deep DDLP correlate with a considerably worse prognosis than those originating in superficial tissues.


Assuntos
Lipoma , Lipossarcoma , Sarcoma , Neoplasias Cutâneas , Feminino , Masculino , Humanos , Idoso , Pele , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/terapia , Lipossarcoma/genética , Proteínas Proto-Oncogênicas c-mdm2/genética
10.
Vet Radiol Ultrasound ; 65(2): 145-148, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38297959

RESUMO

A 12-year-old female spayed Beagle was referred for investigation of exophthalmos. CT revealed a well-defined, retrobulbar mass causing rostro-dorsal displacement of the left globe. The mass had a mildly heterogeneous precontrast soft tissue attenuation with mild heterogeneous enhancement following iohexol administration. The mass was surgically removed en bloc with an orbital exenteration. Histopathology confirmed the mass to be a hibernoma, a benign tumor of brown adipose tissue. Hibernomas have CT characteristics consistent with both benign and malignant adipose tumors and may be underrecognized by radiologists.


Assuntos
Doenças do Cão , Lipoma , Feminino , Cães , Animais , Tomografia Computadorizada por Raios X/veterinária , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Lipoma/veterinária , Olho , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia
11.
In Vivo ; 38(2): 741-746, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38418108

RESUMO

BACKGROUND/AIM: Lipomas are rare but the most common benign mesenchymal lesions of the gastrointestinal (GI) tract, composed of mature adipose cells. The "piggybacking lipoma" is formed by lipomas with overlying polypoid epithelial lesions, such as sessile serrated lesion, tubular adenoma, or hyperplastic polyp, and the literature on these lesions is limited. In this study, we systematically investigated the clinical, endoscopic, and pathologic characteristics of these unique lipomas. PATIENTS AND METHODS: This is a single-institution retrospective study of gastrointestinal tract lipomas diagnosed from 2016-2021. Those with concurrent polypoid epithelial or mesenchymal lesions during the same endoscopic episode were included and reviewed in this study, and the lipomas were classified as "piggybacking lipoma" or "non-piggybacking lipoma" depending on whether the concurrent lesion was overlying the lipoma or was at a different location in the intestine. Demographic, clinical, and endoscopic data were obtained from electronic medical records. RESULTS: A total of 100 lipomas with concurrent epithelial or mesenchymal lesions were included in this study. Among them, 21 cases were classified as "piggybacking lipoma" and 79 were classified as "non-piggybacking lipoma". Patients with piggybacking lipomas showed a female predilection, and were more likely to be symptomatic and less likely to exhibit classic endoscopic features of lipoma. Histologically, the piggybacking polyps showed overlying sessile serrated lesions (SSL) (76.2%) and tubular adenoma (TA) (19%), whereas the non-piggybacking group had differing characteristic lesions with TA (57.5%) and SSL (6.0%). CONCLUSION: Piggybacking lipomas are rare lipomas with overlying polypoid epithelial lesions, most commonly SSL. They present different clinical, endoscopic, and pathologic features compared to non-piggybacking lipomas.


Assuntos
Adenoma , Neoplasias Gastrointestinais , Lipoma , Humanos , Feminino , Estudos de Casos e Controles , Estudos Retrospectivos , Lipoma/patologia , Intestinos
13.
BMJ Case Rep ; 17(2)2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38417947

RESUMO

This report presents a case of an intramuscular lipoma observed in the left back of a healthy female toddler. It was resected after 3 months of observation because of rapid enlargement, raising suspicion of malignancy. Histopathological examination confirmed a diagnosis of intramuscular lipoma without malignant and blastemal components. Intramuscular lipomas are benign neoplasms that mostly appear as a rapidly growing tumour. Several hypotheses regarding the pathogenesis of this characteristic growth pattern have been proposed, including atrophy of the surrounding muscle, reactive adipocytic neoformation and multiple contractive interactions between the lipoma and the surrounding muscle.


Assuntos
Lipoma , Neoplasias Musculares , Humanos , Feminino , Neoplasias Musculares/diagnóstico por imagem , Neoplasias Musculares/cirurgia , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Adipócitos/patologia , Músculos , Diagnóstico Diferencial
14.
BMJ Case Rep ; 17(2)2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38373813

RESUMO

In up to 2% of the population, benign tumours called lipomas can develop. When they are more than 5 cm, they are considered giant lipomas. Giant lipomas of the distal forearm and hand may cause compression to the underlying tissues, nerves and muscles, even though they are typically asymptomatic. An older woman with soft tissue swelling in her right wrist and forearm, and numbness and pain in her right hand presented to the general surgery outpatient clinic. Her numb fingers indicated that the median nerve was compressed, and an MRI scan of her wrist and forearm revealed median nerve compression due to a giant lipoma with a dimension of about 9.2×3.4×4 cm. A surgical excision was done with an intraoperative nerve stimulator, and the specimen sent for histopathology confirmed the diagnosis of lipoma. Pain, numbness and motor power improved within 1 week postoperatively, and the patient was discharged.


Assuntos
Síndrome do Túnel Carpal , Lipoma , Feminino , Humanos , Idoso , Punho/diagnóstico por imagem , Punho/patologia , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/cirurgia , Antebraço/patologia , Hipestesia/etiologia , Lipoma/complicações , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Dor/complicações
16.
Khirurgiia (Mosk) ; (1): 97-101, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38258695

RESUMO

We present a 36-year-old woman with small pelvis lipoma spreading to the gluteal region through the greater sciatic foramen. Resection of lipoma was performed via two accesses (lower median laparotomy and semilunar incision in the gluteal region). The tumor was the content of sciatic hernia that is extremely rare. Combination of surgical approaches can provide favorable outcomes in these patients.


Assuntos
Lipoma , Ferida Cirúrgica , Feminino , Humanos , Adulto , Nádegas/cirurgia , Lipoma/diagnóstico , Lipoma/cirurgia , Laparotomia , Pelve/cirurgia
17.
BMC Neurol ; 24(1): 44, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38273263

RESUMO

BACKGROUND: Wilson's disease (WD) is an inherited disorder of copper metabolism. Agenesis of the corpus callosum is the complete or partial absence of the major united fiber bundles connecting the cerebral hemispheres. Intracranial lipoma is an adipose tissue tumor resulting from an abnormal embryonic development of the central nervous system. The simultaneous occurrence of these three disorders is rare and has not been reported. This report focuses on the pathogenesis and association between the three disorders and highlights the importance of recognizing and effectively managing their coexistence. CASE PRESENTATION: The purpose of this study was to present a patient with coexisting WD, intracranial lipoma, and corpus callosum dysplasia. We reviewed a female patient hospitalized in 2023 with clinical manifestations of elevated aminotransferases and decreased ceruloplasmin, as well as genetic testing for an initial diagnosis of Wilson's disease. Subsequently, a cranial MRI showed corpus callosum dysplasia with short T1 signal changes in the cerebral falx, leading to a final diagnosis of Wilson's disease combined with intracranial lipoma and corpus callosum dysplasia. The patient's WD is currently stable after treatment with sodium dimercaptosulfonamide (DMPS) and penicillamine, and the patient's abnormal copper metabolism may promote the growth of intracranial lipoma. CONCLUSION: The pathogenesis of WD combined with intracranial lipoma and corpus callosum dysplasia is complex and clinically rare. The growth of intracranial lipomas may be associated with abnormal copper metabolism in WD. Abnormal copper metabolism affects lipid metabolism and triggers inflammatory responses. Therefore, early diagnosis and treatment are beneficial for improvement. Each new case of this rare co-morbidity is important as it allows for a better assessment and understanding of these cases' more characteristic clinical manifestations, which can help estimate the course of the disease and possible therapeutic options.


Assuntos
Neoplasias Encefálicas , Degeneração Hepatolenticular , Lipoma , Gravidez , Humanos , Feminino , Degeneração Hepatolenticular/complicações , Degeneração Hepatolenticular/diagnóstico por imagem , Degeneração Hepatolenticular/tratamento farmacológico , Corpo Caloso/diagnóstico por imagem , Corpo Caloso/patologia , Cobre/metabolismo , Penicilamina/uso terapêutico , Lipoma/complicações , Lipoma/diagnóstico por imagem , Lipoma/patologia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia
18.
Surg Pathol Clin ; 17(1): 97-104, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38278611

RESUMO

Atypical spindle cell/pleomorphic lipomatous tumor (ASCPLT) is a rare soft tissue neoplasm, commonly arising in the subcutis (more common than deep soft tissue) of limbs and limb girdles during mid-adulthood. ASCPLT is histologically a lipogenic neoplasm with ill-defined margins composed of a variable amount of spindle to pleomorphic/multinucleated cells within a fibromyxoid stroma. ASCPLTs lack MDM2 amplification, but a large subset show RB1 deletion and variable expression of CD34. Though initially thought to be the malignant form of spindle cell lipoma, ASCPLTs are benign with local recurrences (∼10-15%) and no well-documented dedifferentiation or metastasis.


Assuntos
Lipoma , Lipossarcoma , Neoplasias de Tecidos Moles , Humanos , Adulto , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Lipossarcoma/diagnóstico , Lipossarcoma/genética , Lipoma/diagnóstico , Lipoma/genética , Lipoma/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/patologia
19.
Diagn Cytopathol ; 52(4): E84-E87, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38217263

RESUMO

Spindle cell lipoma (SCL) is a rare form of lipoma, typically occurring as a mass in the back, shoulder or posterior neck of adult males. Most cases present little diagnostic difficulty on fine needle aspiration (FNA), but can be problematic when the SCL is in an unusual location. The authors report a case in the parotid gland in a 75-year-old man. FNA was paucicellular and showed loose collections of spindle cells with mild to moderate atypia, admixed with ropy collagen fibers on a myxoid background. The nuclei showed occasional angulation, interpreted on FNA as suspicious for myoepithelial tumor or low-grade sarcoma. The subsequent excisional specimen was diagnosed as SCL. On retrospective review of the FNA, an additional finding was recognized: 'naked' nuclei with intranuclear lipid vacuoles and positive immunostaining for S100 protein, consistent with Lochkern cells of mature adipocytes. This case highlights the challenges of diagnosing SCL on cytology when no fat-containing cells are apparent on the smear, and stresses the significance of Lochkern cells as a clue for diagnosis.


Assuntos
Lipoma , Glândula Parótida , Adulto , Masculino , Humanos , Idoso , Biópsia por Agulha Fina , Núcleo Celular , Lipoma/diagnóstico , Adipócitos
20.
Zhonghua Bing Li Xue Za Zhi ; 53(2): 168-173, 2024 Feb 08.
Artigo em Chinês | MEDLINE | ID: mdl-38281785

RESUMO

Objective: To investigate the clinicopathological and molecular genetic characteristics of well-differentiated/dedifferentiated liposarcoma (WDLPS/DDLPS) with myxoid-like morphology, and to distinguish them from myxofibrosarcoma (MFS) with similar morphology. Methods: Twenty-nine cases of myxoid-like liposarcoma and 5 cases of MFS were collected from Henan Provincial People's Hospital, Zhengzhou, China and the First Medical Center of PLA General Hospital, Beijing, China from January 2015 to March 2023. Relevant markers were detected using immunohistochemistry and fluorescence in situ hybridization (FISH). The literature was also reviewed. Results: There were 24 males and 10 females, with ages ranging from 41 to 73 years. The tumor sites included retroperitoneum (n=17), abdomen (n=9), lower limbs (n=5), scrotum (n=1), upper limb (n=1) and axilla (n=1). WDLPS was commonly seen as lipomatoid type (12 cases), while the dedifferentiated components of DDLPS included low-grade (13 cases) and high-grade (2 cases) morphology, with low-high grade myxofibrosarcoma, dermatofibrosarcoma protuberans, and low-grade fibrosarcoma structures. Twenty-nine liposarcomas had various proportions of myxoid-like morphology, while 16 showed various degrees of tumor necrosis. The myxoid-like component showed myxoid pleomorphic liposarcoma (MLPS)-like morphology, lobulated growth, characteristic slender, ramified capillary network,"chicken claw-like"morphology, mucus-rich stroma and lung edema-like morphology. Tumor cells were spindle and oval, with many variable vacuolar lipoblasts. MDM2 gene amplification was detected using FISH and present in all tested cases (29/29). DDIT3 break-apart mutation was not detected, but its cluster amplification was present (24/29). Among the MFS cases, one showed cluster amplification (1/5), but no cases showed break-apart or amplification of MDM2 gene. Conclusions: WDLPS/DDLPS with myxoid-like morphology is most commonly seen in the retroperitoneum and abdominal cavity and mostly harbors DDIT3 break-apart probe amplification, while this amplification is not specific to liposarcoma. For core biopsy specimens or very rare tumors in the limbs, when histology has mucinous stroma and MLPS-like morphology, misdiagnosis of MLPS or other non-lipomatous neoplasms with myxoid morphology should be avoided.


Assuntos
Fibrossarcoma , Lipoma , Lipossarcoma Mixoide , Lipossarcoma , Masculino , Feminino , Adulto , Humanos , Hibridização in Situ Fluorescente , Lipossarcoma/patologia , Lipoma/patologia , Biologia Molecular , Proteínas Proto-Oncogênicas c-mdm2/genética , Lipossarcoma Mixoide/genética , Lipossarcoma Mixoide/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...