Liposarcomas of the mediastinum and thorax

A clinicopathologic and molecular cytogenetic study of 24 cases, emphasizing unusual and diverse histologic features

Jennifer M. Boland, Thomas V. Colby, Andrew L. Folpe

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Liposarcoma rarely occurs in the mediastinum, and most reports predate the current genetically based classification system. We report the clinicopathologic and molecular genetic features of a series of thoracic liposarcomas identified over a 60-year period. Twenty-four confirmed cases were reclassified using the most recent World Health Organization classification. Fluorescent in situ hybridization for CPM amplification and/or DDIT3 rearrangement was performed on selected cases. The 24 cases occurred in 13 men and 11 women (mean age, 53 y; range, 15 to 73 y) and arose in all mediastinal compartments. All subtypes were encountered with 8 well-differentiated liposarcomas, 6 dedifferentiated liposarcomas (3 of 6 confirmed CPM+), 7 pleomorphic liposarcomas (2 of 7 confirmed CPM-, 1 of 7 confirmed DDIT3-), 2 myxoid liposarcomas, and 1 unclassifiable liposarcoma (CPM-and DDIT3-). Unusual histologic features included myxoid well-differentiated liposarcoma mimicking myxoid liposarcoma (2 cases), lipoleiomyosarcoma (1 case), dedifferentiated liposarcoma with "meningothelial"-like dedifferentiation, differentiated myxoid liposarcoma mimicking well-differentiated liposarcoma (CPM-), and pleomorphic liposarcoma with epithelioid and myxoid change. Follow-up information was available for 19 patients (mean, 55 mo; range, 8 to 252 mo). Outcome was strongly associated with histologic subtype, with death from disease occurring in 1 of 6 well-differentiated, 1 of 4 dedifferentiated, 5 of 7 pleomorphic, and 2 of 2 myxoid liposarcomas. The mediastinum shows a preponderance of uncommon subtypes and unusual morphologic variants. Correct classification has important implications, with most patients with well-differentiated/dedifferentiated liposarcoma having a protracted clinical course, in contrast to the more rapid disease progression seen in patients with myxoid and pleomorphic liposarcoma.

Original languageEnglish (US)
Pages (from-to)1395-1403
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume36
Issue number9
DOIs
StatePublished - Sep 2012

Fingerprint

Liposarcoma
Mediastinum
Cytogenetics
Thorax
Myxoid Liposarcoma
Prednisolone
Fluorescence In Situ Hybridization
Disease Progression
Molecular Biology

Keywords

  • Liposarcoma
  • mediastinum
  • thorax

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Liposarcomas of the mediastinum and thorax : A clinicopathologic and molecular cytogenetic study of 24 cases, emphasizing unusual and diverse histologic features. / Boland, Jennifer M.; Colby, Thomas V.; Folpe, Andrew L.

In: American Journal of Surgical Pathology, Vol. 36, No. 9, 09.2012, p. 1395-1403.

Research output: Contribution to journalArticle

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