Liposarcoma pathophysiology: Difference between revisions

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According to their class, each liposarcoma will have specific characteristics and pathogenesis:
According to their class, each liposarcoma will have specific characteristics and pathogenesis:
===Well Differentiated Liposarcoma===
===Well Differentiated Liposarcoma===
This type of liposarcoma occurs both at the limbs and retroperitoneum, representing about 45% of liposarcomas.
This type of liposarcoma occurs both at the [[limbs]] and [[retroperitoneum]] in equal frequency, and occasionally at the [[mediastinum]] and [[spermatic cord]], representing about 45% of liposarcomas.<ref name="pmid10982304">{{cite journal| author=Dei Tos AP| title=Liposarcoma: new entities and evolving concepts. | journal=Ann Diagn Pathol | year= 2000 | volume= 4 | issue= 4 | pages= 252-66 | pmid=10982304 | doi=10.1053/adpa.2000.8133 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10982304  }} </ref>


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Spermatic cord and mediastinum represent less-fre- quent but well-known anatomic locations. Morphologi- cally, the WHO classification recognizes three subtypes of well-differentiated liposarcoma: adipocytic (or lipoma- like), sclerosing, and inflammatory. Adipocytic liposar- coma is mostly composed of mature adipocytes exhibit- ing striking variation in cell size and at least focal nuclear atypia and hyperchromasia (Fig 1). Scattered hyperchromatic stromal cells may be encountered within fibrous septa. Of course, a varying number (from many to none) of monovacuolated or multivacuolated lipo- blasts (defined by the presence of single or multiple sharply marginated cytoplasmic vacuoles that indent an enlarged hyperchromatic nucleus) may be found (Fig 2). It is a commonly held opinion that lipoblasts represent the hallmark for any type of malignant adipocytic lesion.  
Morphologi- cally, the WHO classification recognizes three subtypes of well-differentiated liposarcoma: adipocytic (or lipoma- like), sclerosing, and inflammatory. Adipocytic liposar- coma is mostly composed of mature adipocytes exhibit- ing striking variation in cell size and at least focal nuclear atypia and hyperchromasia (Fig 1). Scattered hyperchromatic stromal cells may be encountered within fibrous septa. Of course, a varying number (from many to none) of monovacuolated or multivacuolated lipo- blasts (defined by the presence of single or multiple sharply marginated cytoplasmic vacuoles that indent an enlarged hyperchromatic nucleus) may be found (Fig 2). It is a commonly held opinion that lipoblasts represent the hallmark for any type of malignant adipocytic lesion.  


However, it is important to emphasize that the mere presence of lipoblasts does not make (or is required for) a diagnosis of liposarcoma. As a matter of fact, there exist a number of entirely benign adipocytic lesions (eg, lipoblastoma, pleomorphic lipoma, chondroid lipoma) that may contain numerous lipoblasts. By contrast, the absence of lipoblasts within an adipocytic neoplasm fulfilling all the remaining diagnostic criteria for liposar- coma does not prevent such a diagnosis.
However, it is important to emphasize that the mere presence of lipoblasts does not make (or is required for) a diagnosis of liposarcoma. As a matter of fact, there exist a number of entirely benign adipocytic lesions (eg, lipoblastoma, pleomorphic lipoma, chondroid lipoma) that may contain numerous lipoblasts. By contrast, the absence of lipoblasts within an adipocytic neoplasm fulfilling all the remaining diagnostic criteria for liposar- coma does not prevent such a diagnosis.

Revision as of 15:05, 19 September 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Pathogenesis

According to their class, each liposarcoma will have specific characteristics and pathogenesis:

Well Differentiated Liposarcoma

This type of liposarcoma occurs both at the limbs and retroperitoneum in equal frequency, and occasionally at the mediastinum and spermatic cord, representing about 45% of liposarcomas.[1]


Dedifferentiated Liposarcoma

Myxoid Liposarcoma

Round Cell Liposarcoma

Pleomorphic Liposarcoma

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References

  1. Dei Tos AP (2000). "Liposarcoma: new entities and evolving concepts". Ann Diagn Pathol. 4 (4): 252–66. doi:10.1053/adpa.2000.8133. PMID 10982304.


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