Dedifferentiated liposarcoma with extensive lymphoid component.
An unusual variant of dedifferentiated liposarcoma with extensive lymphocytic component is described. A 71-year-old patient suffered from a relapse of an atypical lipomatous tumor/well-differentiated liposarcoma with early micronodular (low-grade) dedifferentiation, which had been resected 4 years before. The relapse revealed features of a dedifferentiated liposarcoma with spindle-cell, partly pleomorphic dedifferentiation and osseous metaplasia. Clearly separated from the spindle-cell areas, an extensive homogeneously dense lymphoid (lymphocytic) tumor-component was evident, with relative abrupt transition to the well-differentiated liposarcoma component. Using immunohistochemistry and PCR, the lymphoid ("lymphoma-like") infiltrate proved to be a polyclonal lymphocytic proliferation. Fluorescence in situ hybridization (FISII) analysis revealed no signs of MDM2- and CDK4-gene amplification in the lymphoid areas, although within this mononuclear lymphoid population, large polymorphic nuclei displayed an amplified number of MDM2/CDK4 gene copies, indicating the presence of truly dedifferentiated tumor cells within the lymphoid component. The results favor a reactive lymphocytic infiltration versus a neoplastic one, which might be caused for example by chemoattractive agents. An extensive lymphoid "overgrowth" must be considered within the spectrum of unusual variants and in the differential diagnosis of dedifferentiated liposarcoma.
Institute for Pathology, Limb tumor registry, Ruhr-University, University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, D- 44789 Bochum, Germany. cornelius.kuhnen@ruhr-uni-bochum.de
Cornelius
C
Kuhnen
Thomas
T
Mentzel
Raf
R
Sciot
Marcus
M
Lehnhardt
Heinz-Herbert
HH
Homann
Maria
M
Debiec-Rychter
D000368:Aged; D002467:Cell Nucleus / Q000235:genetics / Q000473:pathology; D004273:DNA, Neoplasm / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008080:Liposarcoma / Q000473:pathology* / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology*; D008221:Lymphoid Tissue / Q000473:pathology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
D004273:DNA, Neoplasm