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1.
Pathologe ; 40(4): 339-352, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31240452

RESUMO

More than 20% of soft-tissue tumors belong to the group of adipocytic neoplasms. Difficulties may occur in the differential diagnosis of lipomas versus atypical lipomatous tumors/well-differentiated liposarcomas, in the distinction of dedifferentiated liposarcomas from other soft-tissue sarcoma entities and in the detailed subtyping of liposarcomas. Especially in biopsies, the correct diagnosis and grading may be hampered due to limited tissue. Because of the ever-increasing molecular-pathological knowledge of soft-tissue tumors and the rising distribution of molecular diagnostic assays in institutes of pathology, differential diagnosis has been facilitated, as more than 90% of adipocytic tumors carry more or less specific genomic alterations. In the following, the most important subtypes of adipocytic tumors are described morphologically and genomically.


Assuntos
Lipoma , Lipossarcoma , Neoplasias Lipomatosas , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Lipoma/diagnóstico , Lipoma/patologia , Lipossarcoma/diagnóstico , Lipossarcoma/patologia , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/patologia , Sarcoma/diagnóstico , Sarcoma/patologia , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/patologia
2.
Semin Diagn Pathol ; 36(2): 129-141, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30853315

RESUMO

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.


Assuntos
Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia , Diagnóstico Diferencial , Humanos
3.
Semin Diagn Pathol ; 36(2): 95-104, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30850231

RESUMO

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.


Assuntos
Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/patologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neoplasias Lipomatosas/genética
7.
Sci Rep ; 7(1): 2374, 2017 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-28539662

RESUMO

The extranodal extension (ENE) of nodal metastasis involves the extension of neoplastic cells through the lymph node capsule into the perinodal adipose tissue. This morphological feature has recently been indicated as an important prognostic factor in various cancer types, but its role in prostate cancer is still unclear. We aimed to clarify it, performing the first meta-analysis on this issue, comparing prognostic parameters in surgically treated, node-positive prostate cancer patients with (ENE+) vs. without (ENE-) ENE. Data were summarized using risk ratios (RRs) for number of deaths/recurrences and hazard ratios (HRs), with 95% confidence intervals (CI), for the time-dependent risk related to ENE positivity. Six studies followed-up 1,113 patients with N1 prostate cancer (658 ENE+ vs. 455 ENE-) for a median of 83 months. The presence of ENE was associated with a significantly higher risk of biochemical recurrence (RR = 1.15; 95%CI: 1.03-1.28; I2 = 0%; HR = 1.40, 95%CI: 1.12-1.74; I2 = 0%) and "global" (biochemical recurrence and distant metastasis) recurrence (RR = 1.15; 95%CI: 1.04-1.28; I2 = 0%; HR = 1.41, 95%CI: 1.14-1.74; I2 = 0%). ENE emerged as a potential prognostic moderator, earmarking a subgroup of patients at higher risk of recurrence. It may be considered for the prognostic stratification of metastatic patients. New possible therapeutic approaches may explore more in depth this prognostic parameter.


Assuntos
Linfonodos/patologia , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Lipomatosas/diagnóstico , Neoplasias da Próstata/diagnóstico , Idoso , Humanos , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Lipomatosas/mortalidade , Neoplasias Lipomatosas/secundário , Neoplasias Lipomatosas/cirurgia , Razão de Chances , Prognóstico , Modelos de Riscos Proporcionais , Próstata/patologia , Próstata/cirurgia , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia
8.
Rev. clín. med. fam ; 8(3): 246-250, oct. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-147616

RESUMO

La presencia de una tumoración en tejidos blandos es un motivo de consulta frecuente en Atención Primaria. Una historia clínica completa y una adecuada exploración física son fundamentales para detectar posibles lesiones malignas. Aunque los sarcomas de tejidos blandos pueden aparecer en cualquier lugar del cuerpo, la mayoría se presenta en extremidades o el abdomen. Son un grupo heterogéneo, poco frecuente, de tumores mesenquimales malignos, siendo los liposarcomas los sarcomas más frecuentes del adulto. La cirugía habitualmente es curativa, sola o combinada con radioterapia, con o sin quimioterapia. Preservar la funcionalidad del miembro es el principal objetivo del tratamiento. La detección precoz puede evitar al paciente una cirugía mayor e importantes complicaciones, por lo que debemos estar atentos a los signos clínicos de alarma. Presentamos el caso de una mujer de 54 años con un liposarcoma bien diferenciado, en cara lateral externa del muslo izquierdo (AU)


The presence of a mass involving soft tissues is a frequent reason of consultation in primary health care. A complete clinical history and an appropriate physical examination are fundamental in order to detect possible malignant lesions. Although soft-tissue sarcomas can arise anywhere in the body, the majority appear in the limbs or within the abdomen. Soft-tissue sarcomas are a heterogeneous group of rare malignant mesenchymal tumors, and liposarcomas are the most common sarcoma in adult life. Surgery is often curative, alone or in combination with radiotherapy, with or without chemotherapy, and preserving limb functionality is the goal of treatment. The relevance of early detection could save patients major surgery and serious complications, that is why clinical awareness of the alarm signs should be kept in mind. We present the case of a 54-year-old female with a well-differentiated liposarcoma involving the lateral aspect of the left thigh (AU)


Assuntos
Humanos , Feminino , Adulto , Neoplasias Lipomatosas/metabolismo , Neoplasias Lipomatosas/patologia , Atenção Primária à Saúde , Atenção Primária à Saúde/métodos , Sarcoma/patologia , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Leucocitose/metabolismo , Neoplasias Lipomatosas/complicações , Neoplasias Lipomatosas/diagnóstico , Atenção Primária à Saúde/classificação , Atenção Primária à Saúde/ética , Sarcoma/metabolismo , Metástase Neoplásica/tratamento farmacológico , Metástase Neoplásica/radioterapia , Leucocitose/complicações
9.
Optom Vis Sci ; 92(10): 1021-6, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26258278

RESUMO

PURPOSE: To describe and discuss rare and benign conditions of subconjunctival orbital fat herniation that may mimic adipocytic neoplasm. METHODS: Sixteen eyes of 13 patients with subconjunctival orbital fat herniation were included. They all underwent transconjunctival excision owing to cosmesis, discomfort, or suspicion of malignancy. Histopathologic examination, postoperative complications, and recurrent conditions were analyzed. RESULTS: Eleven male and two female patients were included. The lesion was unilateral in 10 and bilateral in 3 cases. Excision was performed via conjunctival wound and removing the prolapsed orbital fat. The conjunctiva was then closed with two to three interrupted sutures. All the histopathologic specimens revealed Lochkern cells, floret cells, and mature adipocytes separated by fibrovascular septae without hyperchromatic cells, consistent with subconjunctival herniated orbital fat. All the patients were treated successfully with transconjunctival excision without recurrence at an average follow-up of 10.6 months (range, 6 to 16 months). CONCLUSIONS: Prolapse of subconjunctival orbital fat is an uncommon entity of intraorbital masses and may mimic adipocytic neoplasm. It is usually associated with a dehiscence in the Tenon capsule. Surgical excision is indicated and pathologic evaluation is necessary if any malignancy is suspected.


Assuntos
Tecido Adiposo/patologia , Doenças da Túnica Conjuntiva/diagnóstico , Hérnia/diagnóstico , Neoplasias Lipomatosas/diagnóstico , Doenças Orbitárias/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Doenças da Túnica Conjuntiva/cirurgia , Diagnóstico Diferencial , Feminino , Herniorrafia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Orbitárias/cirurgia , Prolapso , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
10.
Int J Gynecol Pathol ; 34(2): 204-7, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25675192

RESUMO

We report 3 cases of the extremely rare lipomatous variant of angiomyofibroblastoma (AMF) involving the vulva of women aged 35, 45, and 47. The lesions ranged in size from 2.5 to 12 cm in maximum dimension and the largest had a gross "fatty" appearance. The percentage of adipose tissue was approximately 50% in 1 case and over 90% in the other 2. In all the cases, there was a background of typical AMF with bland spindled and epithelioid cells arranged around blood vessels, although in the cases with >90% adipose tissue, this was subtle and diffusely interspersed with the adipose tissue. In all the cases, the spindled and epithelioid cells were positive with estrogen receptor. Given the morphologic features, misdiagnosis as a lipomatous neoplasm is likely, especially in cases with a minor component of typical AMF. We review the literature on lipomatous AMF and discuss the differential diagnosis.


Assuntos
Tecido Adiposo/patologia , Angiomioma/diagnóstico , Neoplasias Vulvares/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Lipomatosas/diagnóstico
11.
Ann Pathol ; 35(1): 41-53, 2015 Jan.
Artigo em Francês | MEDLINE | ID: mdl-25533918

RESUMO

Adipocytic tumors are the most common mesenchymal neoplasms, liposarcoma accounting for approximately 20% of soft tissue sarcomas. The differential diagnosis between benign and malignant tumors is often problematic and represents a significant proportion of consultation cases. The goal of this article is to review liposarcoma subtypes, the main benign adipocytic neoplasms: lipoblastoma, hibernoma, spindle/pleomorphic cell lipoma, chondroid lipoma, as well as non adipocytic neoplasms with a lipomatous component such as lipomatous solitary fibrous tumor, emphasizing on practical differential diagnosis issues, and immunohistochemical and molecular tools allowing their resolution.


Assuntos
Neoplasias Lipomatosas/patologia , Angiolipoma/diagnóstico , Angiolipoma/genética , Angiolipoma/patologia , Biomarcadores Tumorais , Diferenciação Celular , Aberrações Cromossômicas , Diagnóstico Diferencial , Humanos , Lipoblastoma/diagnóstico , Lipoblastoma/genética , Lipoblastoma/patologia , Lipoma/diagnóstico , Lipoma/genética , Lipoma/patologia , Lipossarcoma/diagnóstico , Lipossarcoma/genética , Lipossarcoma/patologia , Proteínas de Neoplasias/genética , Neoplasias Lipomatosas/classificação , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/genética , Sarcoma/diagnóstico , Organização Mundial da Saúde
12.
BMC Cancer ; 14: 468, 2014 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-24965044

RESUMO

BACKGROUND: Diagnosing adipocytic tumors can be challenging because it is often difficult to morphologically distinguish between benign, intermediate and malignant adipocytic tumors, and other sarcomas that are histologically similar. Recently, a number of tumor-specific chromosome translocations and associated fusion genes have been identified in adipocytic tumors and atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDL), which have a supernumerary ring and/or giant chromosome marker with amplified sequences of the MDM2 and CDK4 genes. The purpose of this study was to investigate whether quantitative real-time polymerase chain reaction (PCR) could be used to amplify MDM2 and CDK4 from total RNA samples obtained from core-needle biopsy sections for the diagnosis of ALT/WDL. METHODS: A series of lipoma (n = 124) and ALT/WDL (n = 44) cases were analyzed for cytogenetic analysis and lipoma fusion genes, as well as for MDM2 and CDK4 expression by real-time PCR. Moreover, the expression of MDM2 and CDK4 in whole tissue sections was compared with that in core-needle biopsy sections of the same tumor in order to determine whether real-time PCR could be used to distinguish ALT/WDL from lipoma at the preoperative stage. RESULTS: In whole tissue sections, the medians for MDM2 and CDK4 expression in ALT/WDL were higher than those in the lipomas (P < 0.05). Moreover, karyotype subdivisions with rings and/or giant chromosomes had higher MDM2 and CDK4 expression levels compared to karyotypes with 12q13-15 rearrangements, other abnormal karyotypes, and normal karyotypes (P < 0.05). On the other hand, MDM2 and CDK4 expression levels in core-needle biopsy sections were similar to those in whole-tissue sections (MDM2: P = 0.6, CDK4: P = 0.8, Wilcoxon signed-rank test). CONCLUSION: Quantitative real-time PCR of total RNA can be used to evaluate the MDM2 and CDK4 expression levels in core-needle biopsies and may be useful for distinguishing ALT/WDL from adipocytic tumors. Thus, total RNA from core-needle biopsy sections may have potential as a routine diagnostic tool for other tumors where gene overexpression is a feature of the tumor.


Assuntos
Quinase 4 Dependente de Ciclina/genética , Neoplasias Lipomatosas/genética , Neoplasias Lipomatosas/patologia , Proteínas Proto-Oncogênicas c-mdm2/genética , Reação em Cadeia da Polimerase em Tempo Real , Adulto , Idoso , Biomarcadores Tumorais/genética , Biópsia com Agulha de Grande Calibre , Quinase 4 Dependente de Ciclina/metabolismo , Análise Citogenética , Feminino , Proteína HMGA2/genética , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias Lipomatosas/diagnóstico , Proteínas de Fusão Oncogênica/genética , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Adulto Jovem
13.
Histopathology ; 65(2): 273-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24588545

RESUMO

AIMS: Lipomatous tumours of the orbit are rare, and can sometimes be difficult to characterize. Herniated orbital fat is thought to be a reactive process, but its presentation can mimic a lipomatous tumour such as an atypical lipomatous tumour or spindle cell/pleomorphic lipoma. Genetic studies to determine if it is indeed a reactive process rather than an adipocytic neoplasm have not been performed. METHODS AND RESULTS: Four samples of herniated orbital fat were reviewed clinically, histopathologically and immunohistochemically. Array comparative genomic hybridization (aCGH) was used to search for genome-wide copy number alterations within the tumours. Histological evaluation revealed that all four tumours contained collections of adipocytes surrounded by fibrous septae. Lochkern cells and floret-like multinucleated giant cells were present, consistent with herniated orbital fat. CD34 was positive in all tumours. Staining for MDM2 and CDK4 was negative. ACGH analysis demonstrated no copy number alterations. CONCLUSIONS: Herniated orbital fat may share some histopathological features with lipoma and atypical lipomatous tumour, but the absence of copy number gains or losses is consistent with the impression that herniated orbital fat is a reactive process. Genetic analysis may be another method to help differentiate herniated orbital fat from a lipomatous orbital tumour when the diagnosis is in question.


Assuntos
Tecido Adiposo/patologia , Hérnia/diagnóstico , Órbita/patologia , Idoso , Idoso de 80 Anos ou mais , Hibridização Genômica Comparativa , Diagnóstico Diferencial , Dosagem de Genes , Hérnia/genética , Humanos , Imuno-Histoquímica , Lipoma/diagnóstico , Lipoma/genética , Lipossarcoma/diagnóstico , Lipossarcoma/genética , Masculino , Pessoa de Meia-Idade , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/genética , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/genética , Estudos Retrospectivos
14.
Lakartidningen ; 111(38): 1578-80, 2014.
Artigo em Sueco | MEDLINE | ID: mdl-25606657

RESUMO

Most musculoskeletal soft tissue tumors are benign, lipoma being the most common. Malignant soft tissue tumors may be difficult to clinically distinguish from benign. Scandinavian recommendations are that all lesions suspicious for sarcoma be referred to a sarcoma center. This has led to improved tumor control and less post-operative functional deficits. Magnetic resonance imaging (MRI) can reliably diagnose lipomas, and further work-up is not necessary. Lipomas can be treated at the local hospital. All deep seated musculoskeletal tumors (under the muscle fascia) not unequivocally lipomas should be referred to a sarcoma center. All superficial (subcutaneous) musculoskeletal tumors larger than 5 cm and not unequivocally lipomas should be referred to a sarcoma center.


Assuntos
Lipoma/diagnóstico , Neoplasias Lipomatosas/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Adulto , Idoso , Procedimentos Clínicos , Feminino , Humanos , Lipoma/patologia , Lipossarcoma/diagnóstico , Lipossarcoma/patologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neoplasias Lipomatosas/patologia , Encaminhamento e Consulta , Neoplasias de Tecidos Moles/patologia
15.
Int J Clin Exp Pathol ; 7(12): 8899-904, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25674262

RESUMO

Ki-67 expression is an important tool for distinguishing between malignant and benign tumors. It usually shows the nuclear staining. However, the cell membrane staining of MIB-1, which is one of the clones of Ki-67, in the hyalinizing trabecular adenoma of the thyroid gland and other tumors had also been reported. In our practice, we found that the 7B11 antibody could be immunoreactived with the adipose tissues inside or around tumors in the membrane. Thus, in this study, we determined if Ki-67 expression would be useful in recognizing the lipoblasts and adipocytes. The five clones of the Ki-67 antibody, namely, 7B11, K-2, SP5, MIB-1, and SP6 were selected. The adipocytes showed strong 7B11 staining in the cell membrane. The brown fat cells were strongly immunoreactive with 7B11 in the arachnoid layer of the cytoplasm. The adipocytes and brown fat cells showed positive, albeit weaker K-2 staining in the cell membrane and cytoplasm, respectively, compared to 7B11. The adipose tissues and brown fat cells were non-reactive to clones SP5, MIB-1, and SP6. All adipocytes in the lipomas, angiolipomas, uterine lipoleiomyomas, and angioleiomyolipomas showed diffusedly positive 7B11 and K-2 staining in the cell membrane, with stronger immunoreactivity to 7B11 compared with K-2. All hibernomas showed diffusedly cytoplasmic arachnoid staining of 7B11, but only focal to K-2. The lipoblasts in adipocytic tumors also showed positive 7B11 and K-2 staining; however, nearly all of the vacuolated lipoblasts showed strong 7B11 staining, only focal vacuolated lipoblasts in the adipocytic tumors were immunoreactive to K-2 positivity. All other components of the adipocytic tumors were non-reactive to 7B11, K-2, SP5, MIB-1, and SP6 in the cell membrane and cytoplasm. Our results showed that the 7B11 could well help to identify the lipoblasts, which would be useful to diagnose the malignant adipocytic tumors.


Assuntos
Adipócitos/metabolismo , Anticorpos Monoclonais , Imuno-Histoquímica/métodos , Antígeno Ki-67/análise , Neoplasias Lipomatosas/diagnóstico , Adipócitos/patologia , Biomarcadores Tumorais/análise , Humanos
16.
J Am Coll Surg ; 217(5): 881-8, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24074812

RESUMO

BACKGROUND: Differentiating large lipomas from atypical lipomatous tumors (ALT) is challenging, and preoperative management guidelines are not well defined. The diagnostic ambiguity leads many surgeons to refer all patients with large lipomatous masses to an oncologic specialist, perhaps unnecessarily. STUDY DESIGN: In this retrospective cohort study of patients with nonretroperitoneal lipomatous tumors, preoperative characteristics discernible without invasive diagnostic procedures were evaluated for diagnostic predictive value. RESULTS: We identified 319 patients (256 with lipomas, 63 with ALTs) treated between 1994 and 2012. Patients with ALTs were older (60.5 vs 53.5 years, p < 0.0001), had larger tumors (16.0 vs 8.3 cm, p < 0.0001), had tumors more often located on an extremity (88.9% vs 60.5% torso, p < 0.0001), and more frequently had a history of previous operations at the same site, exclusive of excision leading to diagnosis and referral (20.6% vs 5.9%, p = 0.001). Local recurrence was observed in 2 patients with lipomas (0.8%) vs 14 with ALTs (22.6%, p < 0.0001). No patients with ALTs developed distant metastases or disease-specific mortality, with a median follow-up of 27.4 months (range 0 to 164.6 months). On multivariate analysis, age ≥ 55 years, tumor size ≥ 10 cm, extremity location, and history of previous resections were predictors for diagnosis of ALT (p < 0.05). CONCLUSIONS: Characteristics of lipomatous masses associated with a diagnosis of ALT include patient age ≥ 55 years, tumor size ≥ 10 cm, previous resection, and extremity location (vs torso). These easily identifiable traits may guide surgical management or referral to a specialist.


Assuntos
Lipoma/diagnóstico , Lipoma/cirurgia , Oncologia , Especialidades Cirúrgicas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/cirurgia , Encaminhamento e Consulta , Estudos Retrospectivos , Adulto Jovem
17.
J Clin Ultrasound ; 41(7): 424-33, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23836049

RESUMO

Fat-containing breast lesions constitute a heterogeneous group of predominantly benign tumors and non-neoplastic conditions. The role of imaging is to distinguish leave-me-alone lesions from rarely occurring malignant fat-containing tumors that require histologic analysis. Correlating mammographic findings with appearance at ultrasonography often helps in identifying lesions that do not require further work-up. MRI can be valuable to confirm the presence of fat and characterize lesions indeterminate on conventional imaging. The purpose of this multimodality imaging review is to exemplify the radiologic appearances of common and uncommon fat-containing breast lesions to facilitate accurate diagnosis, avoid unnecessary interventions, and ensure appropriate management.


Assuntos
Doenças Mamárias/diagnóstico , Imagem por Ressonância Magnética , Mamografia , Ultrassonografia Mamária , Cisto Mamário/diagnóstico , Neoplasias da Mama/diagnóstico , Diagnóstico Diferencial , Necrose Gordurosa/diagnóstico , Feminino , Hamartoma/diagnóstico , Humanos , Neoplasias Lipomatosas/diagnóstico
19.
Hand Surg ; 18(1): 115-20, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23413865

RESUMO

The most common soft tissue sarcomas of hand are epitheloid sarcomas, synovial sarcomas and malignant fibrous histiocytomas which are high grade, aggressive tumors. Liposarcomas of the hand are extremely rare and to the best of our knowledge less than 20 cases have been reported so far in the literature. Well differentiated spindle cell liposarcoma is an extremely rare subtype of well differentiated liposarcoma/atypical lipomatous tumor which is different from the other subtypes clinicopathologically, genetically and prognostically. Palmar localization of this rare variant of liposarcoma at this site makes ours only the second case reported in the world literature so far. This recently described entity is low grade lesion and the hand surgeons need to adopt a less aggressive approach in the treatment of this subtype.


Assuntos
Mãos , Lipossarcoma/diagnóstico , Neoplasias Lipomatosas/diagnóstico , Diagnóstico Diferencial , Humanos , Lipossarcoma/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Lipomatosas/cirurgia , Procedimentos Ortopédicos/métodos , Fotomicrografia
20.
Appl Immunohistochem Mol Morphol ; 21(5): 408-13, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23197007

RESUMO

Expression of the transducin-like enhancer of split 1 (TLE1) by immunohistochemistry (IHC) has been widely used as a biomarker for the diagnosis of synovial sarcoma. Although TLE1 expression can be identified in more than 90% of synovial sarcomas, positive staining has been reported in up to one third of nonsynovial sarcomas, including peripheral nerve sheath tumors and neoplasms of fibrous and adipose tissues. The low specificity of this test in soft tissue tumors raises concern on its clinical application as a diagnostic biomarker. As synovial sarcoma is frequent among the differential diagnosis of unclassified high-grade sarcomas, and considering that the specificity of TLE1 antibody in this tumor group remains unclear, we evaluated TLE1 expression by IHC in 42 unclassified high-grade sarcomas. SS18 (SYT) gene break-apart analyses by fluorescence in situ hybridization were simultaneously performed as a gold standard biomarker for synovial sarcoma. Five cases that were positive for the SS18 break-apart by fluorescence in situ hybridization were also positive for TLE1 by IHC, whereas the remaining 37 cases negative for SS18 break-apart were all negative for TLE1. The results showed no evidence of nonspecific TLE1 expression in the nonsynovial high-grade sarcomas. We concluded that TLE1 is a highly specific biomarker for synovial sarcoma in the setting of differential diagnosis of unclassified high-grade sarcomas.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Lipomatosas/diagnóstico , Neoplasias de Tecido Fibroso/diagnóstico , Neoplasias da Bainha Neural/diagnóstico , Proteínas de Fusão Oncogênica/metabolismo , Proteínas Repressoras/metabolismo , Sarcoma Sinovial/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Regulação da Expressão Gênica , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Lipomatosas/patologia , Neoplasias de Tecido Fibroso/patologia , Neoplasias da Bainha Neural/patologia , Proteínas Repressoras/genética , Sarcoma Sinovial/patologia , Sensibilidade e Especificidade , Adulto Jovem
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