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Soft Tissue Tumors

Adipose tissue

Inflammatory liposarcoma - subtype of atypical lipomatous tumor / well differentiated liposarcoma


Reviewer: Charanjeet Singh, M.D. (see Reviewerspage)
Revised: 12 November 2012, last major update June 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Nodular aggregates of chronic inflammatory cells with scattered large atypical cells
● Paucicellular stroma with fibroblastic cells
● Remaining lesion is typical well differentiated liposarcoma (Am J Surg Pathol 1997;21:518)
● Not a WHO diagnosis

Epidemiology
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● Rare variant with similar clinical presentation to classic type (Am J Surg Pathol 1997;21:884)

Case reports
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● 37 year old man with 35 cm abdomino-pelvic mass (Indian J Cancer 2006;43:36)
● 67 year old man with diffuse large B cell lymphoma (Patholog Res Int 2010;2010:505436)
● 79 year old woman with thigh mass (Arch Pathol Lab Med 2004;128:e21)

Gross images
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35 cm tumor weighing 9 kg


Retroperitoneal tumor

Micro description
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● Prominent chronic inflammation that resembles lymphoma and may obscure sarcomatous component
● Lymphocytes distributed in 3 distinct patterns:
  (1) Scattered throughout the tumor, both in fibrous septae and in adipocytic areas
  (2) In clusters; or
  (3) As immature follicles
● Clusters and follicles are usually perivascular; vessels are surrounded by lymphocytes, but with no evidence of vasculitis (Am J Surg Pathol 2012;36:941)

Micro images
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Inflammatory variant


Focal dense inflammatory infiltrate


Various images

Cytology description
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● Numerous dispersed lymphocytes and plasma cells
● Scattered large atypical cells with abundant ill defined cytoplasm, multiple or hyperlobated nuclei and coarse chromatin
● Also fibrous tissue fragments containing both types of cells (Diagn Cytopathol 1999;20:229)

Differential diagnosis
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● Hodgkin’s lymphoma - no well differentiated liposarcoma component, no lipoblasts, negative for MDM2, CDK4, 12q13-15 rearrangement
● Inflammatory pseudotumor - no well differentiated liposarcoma component, no lipoblasts, negative for MDM2, CDK4, 12q13-15 rearrangement (Am J Surg Pathol 1997;21:884)
● MFH-inflammatory - no well differentiated liposarcoma component, no lipoblasts, negative for MDM2, CDK4, 12q13-15 rearrangement
● Sclerosing mesenteritis or idiopathic retroperitoneal fibrosis - no well differentiated liposarcoma component, no lipoblasts, negative for MDM2, CDK4, 12q13-15 rearrangement (Mod Pathol 2009;22:66)

End of Soft Tissue Tumors > Adipose tissue > Inflammatory liposarcoma - subtype of atypical lipomatous tumor / well differentiated liposarcoma


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