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Updated: Aug 4, 2025
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
768
Liposarcoma of the pleural cavity
Toshiaki Kawai1, Hiroshi Nakashima2, Kota Washimi3
1Toda Central Medical Laboratory, Toda, 335-0023, Japan.
Human Pathology
|April 6, 2023
Summary
Diagnosing rare pleural liposarcomas requires combining clinicopathologic, immunohistochemical, and fluorescence in situ hybridization methods. These techniques, particularly CDK4, MDM2, adipophilin, and MDM2 gene amplification, aid in definitive diagnosis and prognosis.
Area of Science:
- Oncology
- Pathology
- Genetics
Background:
- Liposarcoma in the pleura or thoracic cavity is exceptionally rare, with limited existing literature.
- Accurate diagnosis of pleural liposarcoma is challenging due to its rarity and potential for varied histological presentations.
Purpose of the Study:
- To investigate the utility of combining clinicopathologic, immunohistochemical, and fluorescence in situ hybridization (FISH) methods for the definitive diagnosis of pleural liposarcoma.
- To evaluate the prognostic factors for survival in patients with pleural liposarcoma.
Main Methods:
- Histopathological examination of formalin-fixed, paraffin-embedded blocks from 14 liposarcoma cases (ALT/WDLPS, DDLPS, pleomorphic, MLPS).
- Immunohistochemical analysis for S-100, p16, CDK4, MDM2, and adipophilin.
- Fluorescence in situ hybridization (FISH) for MDM2 gene amplification.
- Survival analysis using the Kaplan-Meier method and Wilcoxon test.
Main Results:
- Immunohistochemistry showed high positivity for S-100 (79%), p16 (79%), and CDK4 (71%). MDM2 and adipophilin were positive in 43% of cases.
- MDM2 gene amplification by FISH was detected in one ALT/WDLPS and three DDLPS cases.
- Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDLPS) showed the most favorable survival, while adipophilin emerged as a potential negative prognostic factor.
Conclusions:
- A combination of immunohistochemistry (CDK4, MDM2, adipophilin) and MDM2 gene amplification by FISH is crucial for the definitive diagnosis of pleural liposarcoma.
- Understanding the specific subtypes and molecular markers aids in predicting patient prognosis.
- Further research into rare thoracic malignancies is warranted to improve diagnostic accuracy and patient outcomes.
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