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Skeletal Radiol. 2018 Oct;47(10):1371-1382. doi: 10.1007/s00256-018-2940-6. Epub 2018 Apr 16.

Imaging appearance of well-differentiated liposarcomas with myxoid stroma.

Author information

1
Department of Radiology, University of Michigan Hospitals, Taubman Center 2910F, SPC 5326, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5326, USA.
2
Department of Pathology, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5326, USA.
3
Department of Radiology, University of Michigan Hospitals, Taubman Center 2910F, SPC 5326, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5326, USA. yoavm@umich.edu.
4
Department of Pathology, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5326, USA. yoavm@umich.edu.

Abstract

OBJECTIVE:

Describe the imaging appearance of well-differentiated liposarcoma with myxoid stroma (WDLMS) and correlate with histopathology.

MATERIALS AND METHODS:

A keyword search of the institution medical records was performed from 1 January 2000 to 30 June 2017. The histopathology slides of cases identified in this fashion were then reviewed by a pathologist. Additional cases were prospectively collected from extramural referrals and tumor boards. Diagnostic imaging studies of pathologically proven cases of WDLMS were then reviewed in consensus and correlated with pathology.

RESULTS:

Ten cases of pathologically proven WDLMS were identified (7 men, 3 women, ages 26-81). Tumor location included the retroperitoneum (n = 5), thigh (n = 4), and the shin (n = 1). Nine patients had macroscopic fat on imaging. The nonlipomatous components had a variable appearance, including septal, nodular, and lacelike patterns. Two cases included two distinct areas that were predominantly myxoid or lipomatous ("bi-morphic"). One tumor had no macroscopic fat on imaging. On CT, the nonlipomatous nodular components were hypodense/had hypodense areas. On MRI, the nodular components had intermediate/bright T2W signal. Interval nonlipomatous nodular growth was identified in 3 cases.

CONCLUSION:

WDLMS may present on imaging as a mass with variable morphology and amounts of nonlipomatous components. Histopathological diagnosis of WDLMS is challenging and imaging correlation may be helpful, as this tumor may have ≥50% fatty volume, may have a myxoid nodular component or bi-morphic appearance, or may be located in the retroperitoneum, features that are unusual for myxoid liposarcoma. WDLMS with a nodular component cannot be distinguished from dedifferentiated liposarcoma based on imaging alone.

KEYWORDS:

Imaging; Liposarcoma; Myxoid; Well-differentiated

PMID:
29663025
DOI:
10.1007/s00256-018-2940-6
[Indexed for MEDLINE]

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