Cytomorphology of lipomatous tumors of soft tissue. 2003

Kusum Kapila, and Nandita Ghosal, and Satyajit Singh Gill, and Kusum Verma
Cytology Laboratory, Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India. kkapila@yahoo.com

OBJECTIVE To evaluate the cytomorphologic features of benign and malignant lipomatous tumors of soft tissue on fine needle aspirates (FNA) and determine if the variants of liposarcoma could be identified. METHODS FNA of histologically documented benign (51 cases) and malignant (39 cases) lipomatous tumors were reviewed. Twenty-six of the 51 FNA from lipomas and 34 of the 39 FNA from malignant lipomatous tumors were satisfactory for evaluation. RESULTS FNA from 26 cases of lipomas were cellular, with lobulated, fibroadipose tissue. Thin and thick capillaries were seen in 92% and 65% of cases, though a chicken wire vascular pattern was seen in only 4 cases (15%). A cytodiagnosis of liposarcoma could be made in 23 cases (88%), and these could be further subtyped into well-differentiated (4 cases), myxoid (8), pleomorphic (4), round cell (3) and liposarcoma, ?type (4). Only 50% of the well-differentiated liposarcomas, 3 of the 10 pleomorphic liposarcomas and 8 of the 17 myxoid liposarcomas were diagnosed as such on FNA. Cytologic diagnosis of the remaining 9 cases of myxoid liposarcoma were pleomorphic liposarcoma (1); liposarcoma, ?type (3); malignant mesenchymal tumor (1); suspicious for malignancy (2); and benign (2). There were no false positives, but there were 3 false negative cases (1 well-differentiated and 2 myxoid liposarcoma). CONCLUSIONS Lipomas can be diagnosed readily. Arborizing vessels can be seen in lipomas and should be interpreted with caution. Subclassification of liposarcomas on FNA is possible but not very reliable. Myxoid liposarcomas pose a problem, and aspirates from them can mimic a wide range of morphologic subtypes. The role of FNA in identification of variants of liposarcoma is limited.

UI MeSH Term Description Entries
D008067 Lipoma A benign tumor composed of fat cells (ADIPOCYTES). It can be surrounded by a thin layer of connective tissue (encapsulated), or diffuse without the capsule. Fatty Tumor,Hibernoma,Lipoma, Pleomorphic,Atypical Lipoma,Lipomata,Lipomatosis, Multiple,Atypical Lipomas,Fatty Tumors,Hibernomas,Lipoma, Atypical,Lipomas,Lipomas, Atypical,Lipomas, Pleomorphic,Lipomatas,Lipomatoses, Multiple,Multiple Lipomatoses,Multiple Lipomatosis,Pleomorphic Lipoma,Pleomorphic Lipomas,Tumor, Fatty,Tumors, Fatty
D008080 Liposarcoma A malignant tumor derived from primitive or embryonal lipoblastic cells. It may be composed of well-differentiated fat cells or may be dedifferentiated: myxoid (LIPOSARCOMA, MYXOID), round-celled, or pleomorphic, usually in association with a rich network of capillaries. Recurrences are common and dedifferentiated liposarcomas metastasize to the lungs or serosal surfaces. (From Dorland, 27th ed; Stedman, 25th ed) Liposarcoma, Dedifferentiated,Liposarcoma, Pleomorphic,Atypical Lipomatous Tumor,Liposarcoma, Well Differentiated,Well Differentiated Liposarcoma,Atypical Lipomatous Tumors,Dedifferentiated Liposarcoma,Dedifferentiated Liposarcomas,Lipomatous Tumor, Atypical,Liposarcomas,Pleomorphic Liposarcoma,Pleomorphic Liposarcomas,Well Differentiated Liposarcomas
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009389 Neovascularization, Pathologic A pathologic process consisting of the proliferation of blood vessels in abnormal tissues or in abnormal positions. Angiogenesis, Pathologic,Angiogenesis, Pathological,Neovascularization, Pathological,Pathologic Angiogenesis,Pathologic Neovascularization,Pathological Angiogenesis,Pathological Neovascularization
D001808 Blood Vessels Any of the tubular vessels conveying the blood (arteries, arterioles, capillaries, venules, and veins). Blood Vessel,Vessel, Blood,Vessels, Blood
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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