Related Experiment Video
Updated: Mar 13, 2026
Isolation and Characterization of Tumor-initiating Cells from Sarcoma Patient-derived Xenografts
Published on: June 13, 2019
Primary dermal pleomorphic liposarcoma: utility of adipophilin and MDM2/CDK4 immunostainings
Jose L Ramírez-Bellver1, Joaquín López1, Elena Macías1
1Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
Abstract:
Liposarcoma, usually arises in deep soft tissues and pleomorphic liposarcoma (PL), is the rarest histopathologic variant. However, 15 cases of entirely dermal PL have been reported. We describe a case of a 79-year-old man who developed a rapidly growing nodule on his thorax. Excisional biopsy was performed and immunohistochemical studies were carried. The lesion was a well-circumscribed dermal nodule composed of multivacuolated pleomorphic lipoblasts and atypical mitotic figures. Neoplastic cells expressed CD10 and resulted negative S100 protein, Melan-A, MITF-1, AE1/AE3, CD4, CD68 (PGM1), retinoblastoma gene family protein, pericentrine and lysozyme. Adipophilin stain showed the lipid contents in the cytoplasm of the neoplastic cells. MDM2 and CDK4 resulted both negative. A diagnosis of primary dermal PL was made. This case shows the utility of adipophilin immunostaining to prove the lipid contents in neoplastic cells, which has the advantage of using formalin-fixed paraffin-embedded tissue and making needless frozen sections and ultrastructural studies to show these findings. Negative MDM2/CDK4 staining in our case argues against the possibility of dedifferentiated liposarcoma and further supports the diagnosis of true PL.
Insights
Pleomorphic liposarcoma (PL) is a rare cancer. This case highlights adipophilin staining for diagnosing dermal PL, distinguishing it from other liposarcomas.
Area of Science:
- Oncology
- Dermatopathology
- Surgical Pathology
Background:
- Pleomorphic liposarcoma (PL) is the rarest histopathologic variant of liposarcoma, typically arising in deep soft tissues.
- While rare, entirely dermal PL cases have been documented, presenting diagnostic challenges.
Observation:
- A case of a 79-year-old man with a rapidly growing dermal nodule on his thorax is presented.
- Histopathological examination revealed a well-circumscribed dermal nodule with multivacuolated pleomorphic lipoblasts and atypical mitotic figures.
Findings:
- Immunohistochemical studies showed neoplastic cells expressing CD10 and negative for S100 protein, Melan-A, MITF-1, AE1/AE3, CD4, CD68, retinoblastoma gene family protein, pericentrine, and lysozyme.
- Adipophilin staining confirmed intracellular lipid content, while negative MDM2 and CDK4 staining supported a diagnosis of primary dermal PL and argued against dedifferentiated liposarcoma.
Implications:
- Adipophilin immunostaining is a valuable tool for diagnosing primary dermal pleomorphic liposarcoma, utilizing formalin-fixed paraffin-embedded tissue.
- This method obviates the need for frozen sections and ultrastructural studies to demonstrate lipid content in neoplastic cells.
- Negative MDM2/CDK4 staining is crucial for differentiating true PL from dedifferentiated liposarcoma.
