Epithelioid variant of a pleomorphic liposarcoma displaying arborizing vascular arrangements on cytology smears: a case report of an interesting cytomorphologic pattern in an uncommon tumor.
BACKGROUND
There is limited documentation on cytologic features of liposarcomas, especially pleomorphic liposarcomas (PLPSs), in view of their rarity.


METHODS
We present cytomorphologic features of an uncommon case of epithelioid variant of a PLPS appearing as a recurrent mass in a young adult man. Fine needle aspiration cytology smears displayed prominent arborizing vasculature with numerous lipoblasts with well-defined vacuolated cytoplasm, indenting the nuclei. In addition, mitoses were conspicuously noted. Biopsy from the scar recurrence and following wide excision showed a multinodular tumor with solid arrangement of tumor cells, separated by delicate vessels. Cells displayed well defined cytoplasmic borders, including several lipoblasts and focal areas of spindly sarcomatous differentiation. Typical and atypical mitoses were conspicuously seen and myxoid areas were absent. Immunohistochemistry showed diffuse positivity for vimentin and S-100; cytokeratin showed weak, focal cytoplasmic positivity. CD34 highlighted the delicate vasculature on tissue sections. Diagnosis of an epithelioid variant of a PLPS was finally offered.


CONCLUSIONS
This rare case describes cytomorphologic features of an epithelioid variant of a PLPS, including prominent arborizing vasculature, a pattern that has invariably been described in a myxoid liposarcoma. Additionally, presence of numerous lipoblasts and mitoses led to the diagnosis of this rare variant.
Department of Pathology, Tata Memorial Hospital, Dr. Ernest Borges Road, Parel, Mumbai-400012, Maharashtra, India. rekhi.bharat@gmail.com
Bharat
B
Rekhi
Saral
S
Desai
Nirmala A
NA
Jambhekar
D000328:Adult; D003584:Cytological Techniques; D015622:Epithelioid Cells / Q000473:pathology*; D006801:Humans; D008080:Liposarcoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011859:Radiography