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CASES FROM ACKERMAN ACADEMY
Year : 2013  |  Volume : 4  |  Issue : 4  |  Page : 353-354  

Dermpath Quiz


1 Ackerman Academy of Dermatopathology, New York College of Osteopathic Medicine, New York, USA
2 New York College of Osteopathic Medicine, New York, USA
3 Parker Center for Plastic Surgery, Paramus, New Jersey, USA

Date of Web Publication28-Oct-2013

Correspondence Address:
Dirk M Elston
Ackerman Academy of Dermatopathology, New York
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.120684

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How to cite this article:
Kazlouskaya V, Blochin E, Lal K, Parker PM, Elston DM. Dermpath Quiz. Indian Dermatol Online J 2013;4:353-4

How to cite this URL:
Kazlouskaya V, Blochin E, Lal K, Parker PM, Elston DM. Dermpath Quiz. Indian Dermatol Online J [serial online] 2013 [cited 2019 Jul 23];4:353-4. Available from: http://www.idoj.in/text.asp?2013/4/4/353/120684

An asymptomatic well-circumscribed tumor approximately 10 cm in diameter was excised from the back of a 31-year-old male patient [Figure 1]. Physical examination and laboratory investigations were otherwise unremarkable. Histopathological examination of the lesion showed a neoplasm composed of well-differentiated fat divided by collagenous septae [Figure 2]. There was some variation in the size of adipocytes and focal nuclear atypia was noted in areas adjacent to the septae [Figure 3]. The septae themselves contained numerous atypical hyperchromatic cells, some of which were multinucleated. No hypercellular areas or mitotic figures were noted [Figure 4].
Figure 1: Well-circumscribed yellowish tumor approximately 10 cm in diameter

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Figure 2: Neoplasm composed of adipose tissue divided by collagenous septae (H and E, ×40)

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Figure 3: Moderate atypia of nuclei of adipocytes (H and E, ×400)

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Figure 4: The septae themselves contained numerous atypical hyperchromatic cells, some of which were multinucleated. No hypercellular areas or mitotic figures were noted

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The lesion most likely represents?

  1. Dedifferentiated liposarcoma
  2. Hibernoma
  3. Atypical lipomatous tumor (well-differentiated sarcoma)
  4. Spindle cell lipoma
  5. Pleomorphic lipoma




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   References Top

1.Evans HL. Atypical lipomatous tumor, its variants, and its combined forms: A study of 61 cases, with a minimum follow-up of 10 years. Am J Surg Pathol 2007;31:1-14.  Back to cited text no. 1
    
2.Kuhnen C, Mentzel T, Lehnhardt M, Homann HH, Sciot R, Debiec-Rychter M. Lipoma and atypical lipomatous tumor within the same neoplasia: Evidence for a continuous transition. Pathologe 2010;31:129-34.  Back to cited text no. 2
    
3.Kashima T, Halai D, Ye H, Hing SN, Delaney D, Pollock R, et al. Sensitivity of MDM2 amplification and unexpected multiple faint alphoid 12 (alpha 12 satellite sequences) signals in atypical lipomatous tumor. Mod Pathol 2012;25:1384-96.  Back to cited text no. 3
    
4.Thway K, Flora R, Shah C, Olmos D, Fisher C. Diagnostic utility of p16, CDK4, and MDM2 as an immunohistochemical panel in distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors. Am J Surg Pathol 2012;36:462-9.  Back to cited text no. 4
    
5.Mavrogenis AF, Lesensky J, Romagnoli C, Alberghini M, Letson GD, Ruggieri P. Atypical lipomatous tumors/well-differentiated liposarcomas: Clinical outcome of 67 patients. Orthopedics 2011;34:e893-8.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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