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首页> 外文期刊>Indian Journal of Medical and Paediatric Oncology >Analysis of dedifferentiated liposarcomas emphasizing the diagnostic dilemmas
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Analysis of dedifferentiated liposarcomas emphasizing the diagnostic dilemmas

机译：诊断困境强调诊断困境的消化不断脂质瘤分析

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Introduction: Dedifferentiated liposarcoma (DDLPS) is defined as a progression of well-differentiated liposarcoma (WDLPS) to another nonlipogenic sarcoma. Since a variety of heterologous sarcomas can be encountered in dedifferentiation, clinical dilemmas arise. The present study analyzed the role of clinicopathologic and immunohistochemical (IHC) features in the diagnosis of DDLPS and its differentiation from mimics. Materials and Methods: A retrospective and prospective study was conducted wherein all cases of liposarcoma from 2012 to 2017 were reviewed. DDLPS cases were identified among pleomorphic lesions. Clinical and histopathological details for these cases were retrieved from medical records section and department archives. Histomorphology and immunohistochemistry (MDM2, S100, and Ki-67) were analyzed for these cases. Results: Among 37 cases of liposarcomas reviewed, DDLPS was diagnosed in 12 cases (32.4%). Mean age of the patients was 54.3 years with equal gender distribution (M:F =1:1.2). Two patients had recurrent tumors. Most were retroperitoneal (58.3%) with mean duration of symptoms being 8.7 months. Mean tumor dimension was 17.5 cm. High-grade dedifferentiated component was most common (83.3%) with only one case each (8.3%) of low-grade and homologous dedifferentiation. Undifferentiated pleomorphic sarcoma was the frequent nonlipogenic sarcoma. MDM2 overexpression was detected in 100%, focal S100 positivity seen in 66.6%, and mean Ki-67 labeling index was 24. Conclusion: DDLPS exhibits aggressive clinical behavior. Adequate sampling, correlation to clinical details, demonstration of transition from WDLPS to DDLPS aid in narrowing the differentials. Immunostaining with MDM2 helps in definite categorization and S100 highlights lipoblasts, when they are not easily identifiable. MDM2, CDK4, and p16 IHC panel is recommended in all cases and fluorescence in situ hybridization analysis where IHC is noncontributory.
机译：介绍：去脱脂脂质瘤（DDLPS）被定义为良好分化的脂肪糖瘤（WDLP）的进展到另一个非胰岛素肉瘤。由于在去除湿中可以遇到各种异源肉瘤，因此出现临床困境。本研究分析了临床病理和免疫组织化学（IHC）特征在DDLPS诊断中的作用及其与模拟物的分化。材料和方法：进行了回顾性和预期研究，其中综述了2012年至2017年的所有脂质糖瘤病例。在茂物体病变中鉴定了DDLPS病例。从医疗记录部分和部门档案中检索这些病例的临床和组织病理细节。对这些病例分析组织形态和免疫组织化学（MDM2，S100和KI-67）。结果：37例脂质糖瘤患者，DDLPS在12例（32.4％）中被诊断出来。患者的平均年龄为54.3岁，平等性别分布（M：F = 1：1.2）。两名患者具有复发性肿瘤。大多数是腹膜腹膜（58.3％），症状的平均持续时间为8.7个月。平均肿瘤尺寸为17.5厘米。高级去脱脂组分最常见（83.3％），每种情况下只有一种（8.3％）的低级和同源消化剂。未分化的亲主肉瘤是常见的非疟原虫肉瘤。 MDM2过表达在100％中检测到，局灶性S100阳性以66.6％，平均ki-67标记指数为24.结论：DDLP表现出侵略性的临床行为。充分的采样，与临床细节的相关性，从WDLP到DDLPS帮助的转变缩小差异。用MDM2免疫染色有助于在明确的分类和S100突出脂质细胞中，当它们不易识别时。在所有情况下，建议在所有情况下都建议使用MDM2，CDK4和P16 IHC面板，其原位杂交分析是非杂交分析。

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