Argani P, Facchetti F, Inghirami G, Rosai J
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Am J Surg Pathol. 1997 Aug;21(8):884-95. doi: 10.1097/00000478-199708000-00002.
Nine well-differentiated liposarcomas with foci simulating the appearance of malignant lymphoma and other lymphoid disorders are reported. Their clinical presentation and evolution were not significantly different from those of their conventional counterparts lacking a lymphoid infiltrate. Microscopically, these tumors were characterized by areas of ordinary well-differentiated liposarcoma, admixed with discrete nodules comprised of small germinal centers, and separated by an admixture of lymphocytes, spindled stromal cells, collagen, and blood vessels, in which highly atypical tumor cells were embedded. The differential diagnosis included Hodgkin's disease, Castleman's disease, and inflammatory pseudotumor. Immunohistochemical evaluation revealed a pre-dominance of T cells in the lymphocytic population. Molecular genetic studies revealed no evidence of clonal rearrangement of the T cell receptor gene, supporting the interpretation of these lymphocytes as reactive. Awareness of the existence of this variant of inflammatory liposarcoma should prevent its misinterpretation as a primary lymphoproliferative process.
报告了9例高分化脂肪肉瘤，其病灶模拟恶性淋巴瘤和其他淋巴样疾病的外观。它们的临床表现和病程与缺乏淋巴浸润的传统同类肿瘤无显著差异。显微镜下，这些肿瘤的特征是存在普通高分化脂肪肉瘤区域，混有由小生发中心组成的离散结节，并被淋巴细胞、梭形基质细胞、胶原和血管混合分隔，其中嵌入了高度非典型的肿瘤细胞。鉴别诊断包括霍奇金病、Castleman病和炎性假瘤。免疫组化评估显示淋巴细胞群中T细胞占优势。分子遗传学研究未发现T细胞受体基因克隆重排的证据，支持将这些淋巴细胞解释为反应性淋巴细胞。认识到这种炎性脂肪肉瘤变体的存在应可防止将其误诊为原发性淋巴增殖性疾病。
