Liposarcoma differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Liposarcoma must be differentiated from other diseases that cause a painless, growing mass such as spindle cell lipoma, neurofibroma, dermatofibrosarcoma protuberans, and malignant peripheral nerve sheath tumor.
Differential diagnosis
Differential diagnosis of liposarcoma includes nonadipocytic lesions such as:[1]
- Inflammatory myofibroblastic tumor
- Castleman’s disease
- Spindle cell lipoma
- Neurofibroma
- Dermatofibrosarcoma protuberans
- Malignant peripheral nerve sheath tumor
| Disease | Description |
|---|---|
| Spindle cell lipoma | Composed of bland, sometimes palisading, CD34-positive spindle cells, ad- mixed with eosinophilic refractile collagen bundles |
| Neurofibroma | Characterized by a less cellular S-100– positive spindle cell proliferation with wavy nuclei |
| Dermatofibrosarcoma protuberans | Cytologically bland, monomorphic CD34-positive spindle cell proliferation organized in a distinctive storiform growth pattern and characterized by tendency to infiltrate the surrounding fat in a peculiar ‘‘honeycomb’’ pattern |
| Malignant peripheral nerve sheath tumor | Generally highly cellular tumors composed of tapering or wavy spindle cells featuring perivascular accentuation and focal S-100– positive immunoreactivity in approximately 50% of cases[1] |
| Disease | Clinical feature | Laboratory findings | Imaging findings | ||
|---|---|---|---|---|---|
| Fever | Weight loss | Abdominal pain | |||
| Retroperitoneal hematoma | ✔ | Anemia | MRI is the best radiologic tool to differentiate between retroperitoneal masses. | ||
| Retroperitoneal abscess | ✔ | ✔ | Leukocytosis, positive inflammatory markers | ||
| Retroperitoneal tumors (.e.g. liposarcoma) | ✔ | ✔ | ✔ | positive tumor marker | |
| Chronic pancreatitis | ✔ | ✔ | DM type II, amylase and lipase levels may be slightly elevated | ||
References
- ↑ 1.0 1.1 Dei Tos AP (2000). "Liposarcoma: new entities and evolving concepts". Ann Diagn Pathol. 4 (4): 252–66. doi:10.1053/adpa.2000.8133. PMID 10982304.