Liposarcoma biopsy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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The definitive diagnosis of liposarcoma is made by biopsy, which also provides histopathological classification of the liposarcoma's subtype.

## Biopsy

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Although imaging may be helpful in the diagnosis of liposarcoma, the optimal method for diagnosis of liposarcoma is by biopsy. A biopsy also provides important histopathological information requires to identify the subtype of the liposarcoma.

Subtype | Findings
Atypical Lipomatous Neoplasm (ALN)/Well-Differentiated Liposarcoma (WDL)  | 4 subtypes:

* Lipoma-like

* Sclerosing

* Spindle cell

* Inflammatory

Multivacuolated lipoblasts and spindle cells with hyperchromatic nuclei are often observed.
Other findings include fibrotic areas and atypical stroma cells.

De-differentiated Liposarcoma  | Abrupt transition from a low-grade to a high-grade differentiation within the same mass of a well-differentiated liposarcoma.
Myxoid liposarcoma  | Multinodular mass with round cells and hyaluronic acid matrix.
High cellularity at the periphery and low cellularity at the center of the mass. Mitotic activity is normal and the nuclei are normochromatic.
Pleomorphic liposarcoma  | Pleomorphic lipoblasts with hyperchromatic nuclei, acidophilic cytoplasm, and eosinophilic hyaline globules.
Spindle cells and multinucleated giant cells may be observed.
Mixed-type Liposarcoma  | Mixed features of myxoid, pleomorphic, and well-differentiated liposarcoma.
Table adapted from Fletcher CDM, Unni KK, Mertens F, eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Geneva:IARC Press; 2002[1] and Enzinger and Weiss's Soft Tissue Tumors , 6th Edition [2]

Well-differentiated liposarcoma.
Retrieved from Wikimedia Commons. Original image courtesy of Panoraia Paraskeva, Paraskevas Katsaronis, Eleftherios D Spartalis, et al. Giant liposarcoma of the back with 4 types of histopathology: a case report. Cases Journal. 2009; 2:9339(Open Access) | De-differentiated liposarcoma.
Retrieved from Wikimedia Commons. Image by user: Nephron, licensed under GNU Free Documentation License | De-differentiated liposarcoma.
Retrieved from Wikimedia Commons. Image by user: Nephron, licensed under GNU Free Documentation License

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De-differentiated liposarcoma.
Retrieved from Wikimedia Commons. Image by user: Nephron, licensed under GNU Free Documentation License | De-differentiated liposarcoma.
Retrieved from Wikimedia Commons. Image by user: Nephron, licensed under GNU Free Documentation License

## References

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1. ↑ Fletcher, Christopher (2002). Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press. ISBN 9283224132.
2. ↑ Goldblum, John (2014). Enzinger and Weiss's soft tissue tumors. Philadelphia, PA: Saunders/Elsevier. ISBN 978-0-323-08834-3.

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