Cogan Ophthalmic Pathology Laboratory, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts 02114, USA.
Ophthalmic Plast Reconstr Surg. 2010 Nov-Dec;26(6):413-5. doi: 10.1097/IOP.0b013e3181cd62eb.
To distinguish, in a 36-year-old man, an atypical lipomatous neoplasm/well-differentiated liposarcoma from a spindle cell lipoma in a recurrent orbital tumor.
Clinical, radiographic, and histopathologic evaluations coupled with immunohistochemical studies for CD34, factor XIII, bcl-2, S-100, muscle-specific actin, Ki-67, and MDM2.
MDM2 gene amplification was discovered in the CD34 tumor cells. An average Ki-67 proliferation index of 28% was ascertained for the original and recurrent lesions. These findings established the diagnosis of a well-differentiated liposarcoma with lipoma-like and spindle cell features and ruled out a spindle cell lipoma.
Well-differentiated liposarcoma is a slow growing, infiltrative, and nonmetastasizing neoplasm that is microscopically and diagnostically challenging. It can be reliably separated from a benign spindle cell or an atypical lipoma by using the markers MDM2 and Ki-67.
在一名 36 岁男性的复发性眼眶肿瘤中，区分非典型脂肪瘤性肿瘤/高分化脂肪肉瘤与梭形细胞脂肪瘤。
临床、影像学和组织病理学评估，结合免疫组织化学研究，用于检测 CD34、因子 XIII、bcl-2、S-100、肌特异性肌动蛋白、Ki-67 和 MDM2。
在 CD34 肿瘤细胞中发现了 MDM2 基因扩增。对原始和复发性病变进行了平均 28%的 Ki-67 增殖指数检测。这些发现确立了具有脂肪瘤样和梭形细胞特征的高分化脂肪肉瘤的诊断，并排除了梭形细胞脂肪瘤。
高分化脂肪肉瘤是一种生长缓慢、浸润性且不转移的肿瘤，在显微镜下和诊断上具有挑战性。通过使用 MDM2 和 Ki-67 标志物，可以可靠地区分良性梭形细胞或非典型脂肪瘤。
