首页> 外文期刊>American Journal of Surgical Pathology >Overlapping features between dedifferentiated liposarcoma and undifferentiated high-grade pleomorphic sarcoma.
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Overlapping features between dedifferentiated liposarcoma and undifferentiated high-grade pleomorphic sarcoma.

机译:未分化的脂肪肉瘤与未分化的高度多形性肉瘤之间有重叠特征。

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摘要

Dedifferentiated liposarcoma (DDL), occurring in up to 10% of well differentiated liposarcoma cases, has similar histologic features to that of undifferentiated high-grade pleomorphic sarcoma (UHGPS); the former develops in a background of atypical lipomatous tumors/well differentiated liposarcoma, whereas the latter shows no specific line of differentiation. The retroperitoneum and thigh represent the most common anatomic locations for both the sarcomas. Despite their morphologic similarity, the issue of whether these 2 sarcomas share overlapping immunohistochemical and molecular features has not been well studied. We examined the expression of the lipogenic tumor-related markers peroxisome proliferator-activated receptor gamma (PPAR-gamma), CDK4, and MDM2 in 15 cases of DDL and 45 cases of retroperitoneal/thigh UHGPS. Patients with DDL ranged from 31 to 82 years (mean 63 y) with a male:female ratio of 5:3. Patients with UHGPS ranged from 14 to 80 years (mean 52 y) with a male:female ratio of 3:2. All 15 DDLs expressed CDK4 and MDM2 (100%), and 8 of 15 cases expressed PPAR-gamma (53%). Twenty-three of 45 (51%) UHGPS expressed at least 1 of these 3 markers. We also studied MDM2 and CDK4 gene amplification by fluorescence in situ hybridization in 28 immunohistochemically positive cases, including 5 DDLs and 23 UHGPSs. All 5 cases of DDL showed MDM2 and/or CDK4 amplification (100%), whereas 6 of 45 UHGPSs showed MDM2 and/or CDK4 amplification (13%). Our results demonstrate that (1) the lipogenic tumor markers CDK4 and MDM2 can be used as surrogate immunohistochemical markers for the diagnosis of malignant lipomatous tumors with high sensitivity; (2) approximately 26% of retroperitoneal/thigh UHGPS cases that were positive for PPAR-gamma, CDK4, or MDM2 by immunohistochemistry showed characteristic CDK4 and MDM2 gene amplification, suggesting that a subset of UHGPS cases represent DDL despite lacking histologic evidence of lipoblasts.
机译:高分化脂肪肉瘤病例中多达10%发生的去分化脂肪肉瘤(DDL)具有与未分化高级多形性肉瘤(UHGPS)相似的组织学特征;前者在非典型脂瘤性肿瘤/高度分化的脂肪肉瘤的背景下发展,而后者则没有特异性分化线。腹膜后和大腿代表两个肉瘤最常见的解剖位置。尽管它们的形态相似,但这两个肉瘤是否具有重叠的免疫组织化学和分子特征的问题尚未得到很好的研究。我们检查了15例DDL和45例腹膜后/大腿UHGPS患者中脂原性肿瘤相关标志物过氧化物酶体增殖物激活受体γ(PPAR-γ),CDK4和MDM2的表达。 DDL患者的年龄为31至82岁(平均63岁),男女之比为5:3。 UHGPS患者的年龄为14至80岁(平均52岁),男女之比为3:2。所有15个DDL均表达CDK4和MDM2(100%),而15例病例中有8个表达PPAR-γ(53%)。 45个UHGPS中的23个(至少51个)表达了这3个标记中的至少1个。我们还研究了28例免疫组织化学阳性病例(包括5个DDL和23个UHGPS)中通过荧光原位杂交进行的MDM2和CDK4基因扩增。所有5例DDL病例均显示MDM2和/或CDK4扩增(100%),而45个UHGPS中有6例显示MDM2和/或CDK4扩增(13%)。我们的结果表明:(1)脂生性肿瘤标志物CDK4和MDM2可作为免疫组化的替代标志物,用于高灵敏度诊断恶性脂肪瘤。 (2)大约26%的腹膜后/大腿UHGPS病例通过免疫组织化学对PPAR-γ,CDK4或MDM2呈阳性,表现出特征性CDK4和MDM2基因扩增,这表明尽管缺乏成脂细胞的组织学证据,但一部分UHGPS病例仍代表DDL。

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