Open AccessFine needle aspiration biopsy diagnosis of dedifferentiated liposarcoma: Cytomorphology and MDM2 amplification by FISH
Author(s) -
Hatem Q. Al-Maghraby,
Walid E. Khalbuss,
Uma Rao,
Kathleen Cieply,
Sanja Đačić,
Sara Monaco
Publication year - 2010
Publication title -
cyto journal/cytojournal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.371
H-Index - 27
eISSN - 0974-5963
pISSN - 1742-6413
DOI - 10.4103/1742-6413.62257
Subject(s) - liposarcoma , pathology , fine needle aspiration , soft tissue , fluorescence in situ hybridization , biopsy , sarcoma , leiomyosarcoma , biology , medicine , biochemistry , chromosome , gene
Lipomatous mesenchymal tumors constitute the most common type of soft tissue tumors. Well-differentiated liposarcoma (WDLS) can undergo dedifferentiation to a nonlipogenic sarcoma of variable histologic grade. In the recent literature, amplification of the murine double minute 2 (MDM2) oncogene, which has a role in cell cycle control, has been successful in distinguishing WDLS from benign lesions. We present a case of dedifferentiated liposarcoma diagnosed by fine-needle aspiration (FNA), using cytomorphology and ancillary studies (immunocytochemistry and fluorescent in-situ hybridization). An 85-year old female presented to our institution with a firm soft tissue mass of the right buttock. The FNA showed atypical spindle cells, osteoclast-like giant cells and extracellular dense matrix material. The cell block showed cellular groups of highly atypical spindle cells with osteoid and adipose tissue. Fluorescence in situ hybridization (FISH) studies performed on the cell block demonstrated amplification of the MDM2 gene. In addition, the findings were morphologically compatible with the previously resected retroperitoneal dedifferentiated liposarcoma with areas of osteosarcoma. This rare case illustrates the usefulness of FNA and ancillary studies in the diagnosis and subclassification of soft tissue tumors. To the best of our knowledge, this is the first report of MDM2 FISH positivity in a liposarcoma diagnosed by FNA.