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Related Experiment Video

Updated: Jul 16, 2026

Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models
08:57

Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models

Published on: May 17, 2024

Atypical Spindle Cell/Pleomorphic Lipomatous Tumor with Atypical Imaging Features.

Jiro Ichikawa1, Tomonori Kawasaki2, Kojiro Onohara3

  • 1Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, Japan.

Diagnostics (Basel, Switzerland)
|July 15, 2026
PubMed
Summary

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Diagnosing atypical spindle cell/pleomorphic lipomatous tumors (ASPLTs) is challenging due to overlapping imaging features with other lipomatous lesions. This case highlights the need for molecular testing alongside histology for accurate ASPLT diagnosis and management.

Area of Science:

  • Orthopedic Surgery
  • Oncology
  • Radiology

Background:

  • Atypical spindle cell/pleomorphic lipomatous tumors (ASPLTs) present diagnostic challenges due to variable imaging characteristics.
  • Distinguishing ASPLTs from benign lipomatous tumors like spindle cell lipoma (SCL) and atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) on MRI can be difficult.

Purpose of the Study:

  • To report a case of ASPLT with atypical radiological findings.
  • To emphasize the diagnostic difficulties in differentiating ASPLT from SCL and ALT/WDL based solely on imaging.
  • To highlight the importance of integrating histological and molecular findings for accurate ASPLT diagnosis.

Main Methods:

  • En bloc surgical excision of a wrist mass.
  • Histopathological examination including mature adipocytes, atypical spindle cells, myxoid stroma, and lipoblasts.
Keywords:
atypical spindle cell/pleomorphic lipomatous tumordifferential diagnosishistopathologyimaging

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Last Updated: Jul 16, 2026

Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models
08:57

Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models

Published on: May 17, 2024

  • Immunohistochemistry (CD34 positivity, RB1 loss) and fluorescence in situ hybridization (FISH) for MDM2 amplification absence.

    • Main Results:

    • The resected tumor exhibited features suggestive of ASPLT, despite initial atypical MRI findings.
    • Immunohistochemistry confirmed CD34 positivity and RB1 loss.
    • FISH analysis revealed no MDM2 amplification, supporting the ASPLT diagnosis.

    Conclusions:

    • ASPLTs demonstrate diverse morphological and radiological presentations, complicating preoperative diagnosis.
    • Accurate diagnosis of ASPLT requires a combination of imaging, histology, and molecular testing.
    • Surgical excision is the primary treatment for ASPLT, with rare recurrence and exceedingly rare metastasis.