Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Histopathology. 2013 May;62(6):925-30. doi: 10.1111/his.12100. Epub 2013 Apr 12.
Chondroid lipomas are benign adipose tissue tumours. Their rarity and peculiar morphology can lead to misinterpretation, especially in small biopsies. Based on a recurrent translocation t(11;16)(q13;p13), the C11orf95-MKL2 fusion gene has been found in a few cases. Therefore, it seemed appropriate to look for this fusion gene in a larger cohort.
We describe eight further cases from four females and four males with an age range of 21-81 years (median 49 years). The tumours were situated in the lower arm (three), lower leg (two), thigh (one), back (one) and head (one); seven lesions were deep-seated and one was located subcutaneously. Sizes ranged from 3 to 12 cm (median 6.3 cm). All patients were treated by simple excision, and follow-up, available for six patients (range 2 months-12 years; median 15 months), demonstrated recurrence in one case. Histologically, the circumscribed and lobulated tumours showed a variable composition of adipocytes, lipoblasts, hibernoma-like cells and chondroblast-like cells embedded in a chondroid matrix. Immunohistochemistry, performed in four cases, revealed positivity for S-100 and pancytokeratin in two of three neoplasms stained for each marker. A C11orf95-MKL2 fusion gene was shown by RT-PCR analysis in seven of the eight cases.
Molecular analysis can be used to support the diagnosis of chondroid lipoma, especially in small samples. This may be helpful in planning treatment when the differential diagnosis includes malignant lesions.
软骨样脂肪瘤是良性脂肪组织肿瘤。其罕见性和特殊形态学特征可能导致误诊,尤其是在小活检中。基于反复出现的易位 t(11;16)(q13;p13),已经在少数病例中发现了 C11orf95-MKL2 融合基因。因此,在更大的队列中寻找这种融合基因似乎是合适的。
我们描述了来自 4 名女性和 4 名男性的另外 8 例病例,年龄范围为 21-81 岁(中位数 49 岁)。肿瘤位于前臂(3 例)、小腿(2 例)、大腿(1 例)、背部(1 例)和头部(1 例);7 个病变位于深部,1 个位于皮下。大小范围从 3 到 12 厘米(中位数 6.3 厘米)。所有患者均行单纯切除术治疗,6 例患者可获得随访(范围 2 个月至 12 年;中位数 15 个月),其中 1 例复发。组织学上,边界清楚和分叶状肿瘤表现出不同程度的脂肪细胞、脂肪母细胞、冬眠瘤样细胞和软骨母细胞样细胞组成,嵌入软骨样基质中。4 例进行了免疫组织化学染色,两种标志物均显示 3 种肿瘤中的 2 种肿瘤中 S-100 和细胞角蛋白阳性。RT-PCR 分析显示 8 例中的 7 例存在 C11orf95-MKL2 融合基因。
分子分析可用于支持软骨样脂肪瘤的诊断,尤其是在小样本中。当鉴别诊断包括恶性病变时,这可能有助于制定治疗计划。