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一例伴有内镜形态学改变的胃非典型脂肪瘤样肿瘤/高分化脂肪肉瘤

A Case of Gastric Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma With Endoscopic Morphological Changes.

作者信息

Omote Rika, Omote Shizuma, Sonobe Hiroshi, Hamano Ryosuke, Toyokawa Tatsuya, Otsuka Shinya, Tanaka Takehiro, Yanai Hiroyuki, Inagaki Masaru, Yamamoto Hidetaka

机构信息

Department of Diagnostic Pathology NHO Fukuyama Medical Center Hiroshima Japan.

Department of Internal Medicine Fukuyama Minami Hospital Hiroshima Japan.

出版信息

DEN Open. 2025 May 22;6(1):e70146. doi: 10.1002/deo2.70146. eCollection 2026 Apr.

DOI:10.1002/deo2.70146
PMID:40416586
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12098964/
Abstract

Atypical lipomatous tumor/well-differentiated liposarcoma is a locally aggressive mesenchymal neoplasm composed of adipocytes and stromal cells. Gastric cases are exceedingly rare, and their malignant potential remains unclear. We report a case of a woman in her 60s who was found to have multiple submucosal tumor-like lesions of the stomach. Over time, the tumors increased in size, requiring a laparoscopic partial gastrectomy. Histological examination revealed a tumor composed of both fatty tissue and fibrous stroma with nuclear atypia. Immunohistochemistry showed positivity for CDK4 and MDM2, and fluorescence in situ hybridization confirmed amplification, leading to a diagnosis of atypical lipomatous tumor/well-differentiated liposarcoma. This case presented an unusual gastric manifestation, with multiple submucosal tumor-like lesions on endoscopy and exhibiting progressive morphological changes over several years.

摘要

非典型脂肪瘤性肿瘤/高分化脂肪肉瘤是一种由脂肪细胞和基质细胞组成的具有局部侵袭性的间叶性肿瘤。胃的病例极为罕见，其恶性潜能仍不明确。我们报告一例60多岁女性，发现其胃有多个黏膜下肿瘤样病变。随着时间推移，肿瘤体积增大，需行腹腔镜部分胃切除术。组织学检查显示肿瘤由脂肪组织和纤维性基质组成，伴有核异型性。免疫组化显示CDK4和MDM2呈阳性，荧光原位杂交证实有扩增，从而诊断为非典型脂肪瘤性肿瘤/高分化脂肪肉瘤。该病例呈现出不寻常的胃部表现，内镜检查可见多个黏膜下肿瘤样病变，并在数年内呈现出渐进性形态变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/3194cb1e925e/DEO2-6-e70146-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/b9cc64ed0f01/DEO2-6-e70146-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/a5e37dab1ea2/DEO2-6-e70146-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/b1e8f43148ac/DEO2-6-e70146-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/3194cb1e925e/DEO2-6-e70146-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/b9cc64ed0f01/DEO2-6-e70146-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/a5e37dab1ea2/DEO2-6-e70146-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/b1e8f43148ac/DEO2-6-e70146-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2436/12098964/3194cb1e925e/DEO2-6-e70146-g002.jpg

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Cellular origin and clonal evolution of human dedifferentiated liposarcoma.人类去分化脂肪肉瘤的细胞起源和克隆进化。
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Can MDM2 analytical tests performed on core needle biopsy be relied upon to diagnose well-differentiated liposarcoma?核心针活检上进行的 MDM2 分析检测能否可靠诊断为高分化脂肪肉瘤？
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Dedifferentiated liposarcoma: a clinicopathological analysis of 155 cases with a proposal for an expanded definition of dedifferentiation.去分化脂肪肉瘤：155例临床病理分析及去分化扩展定义的提议
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