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Atypical spindle cell/pleomorphic lipomatous tumor.

Evelyne Lecoutere1, David Creytens1,2

  • 1Department of Pathology, Ghent University and Ghent University Hospital, Ghent, Belgium.

Histology and Histopathology
|February 19, 2020
PubMed
Summary

Atypical spindle cell/pleomorphic lipomatous tumor (ASPLT) is a new, indolent adipocytic tumor entity. Diagnosis is challenging due to varied histology and overlap with mimics, but lacks MDM2/CDK4 amplification.

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Area of Science:

  • Oncology
  • Pathology
  • Genetics

Background:

  • Atypical spindle cell/pleomorphic lipomatous tumor (ASPLT) is a newly recognized, low-grade adipocytic tumor.
  • ASPLT will be included in the upcoming 5th edition of the WHO Classification of Soft tissue and Bone tumors.
  • Histological features include atypical spindle cells, adipocytes, lipoblasts, and pleomorphic multinucleated cells with variable matrix.

Purpose of the Study:

  • To provide an overview of the clinical and pathological features of ASPLT.
  • To detail the differential diagnoses for ASPLT.
  • To highlight diagnostic challenges and molecular findings.

Main Methods:

  • Review of current literature on ASPLT.
  • Analysis of histological characteristics.
  • Summary of molecular findings, including gene amplifications and deletions.

Main Results:

  • ASPLTs exhibit variable histology with potential overlap with other tumors, making diagnosis challenging.
  • Consistent absence of MDM2 or CDK4 amplification is noted in ASPLTs.
  • Deletions or losses of 13q14, including RB1, are identified in a subset of ASPLT cases.

Conclusions:

  • ASPLT is a distinct adipocytic tumor entity with specific, albeit variable, histological features.
  • Diagnostic challenges necessitate careful evaluation and consideration of molecular data.
  • Understanding the molecular landscape, particularly RB1 alterations, is crucial for ASPLT characterization.