Atypical lipomatous tumor, its variants, and its combined forms - A study of 61 cases, with a minimum follow-up of 10 years
Atypical lipomatous tumor, its variants, and its combined forms - A study of 61 cases, with a minimum follow-up of 10 years
复制标题
DOI：
10.1097/01.pas.0000213406.95440.7a
复制
发表时间：
2007-01-01
影响因子：
5.6
通讯作者：
Evans, Harry L.
中科院分区：
文献类型：
--
作者：
Evans, Harry L.
本文复习了61例全部或部分由非典型脂肪瘤构成的肿瘤。最短随访时间为10年。根据首次切除标本分为4组：传统型非典型脂肪瘤15例，细胞型非典型脂肪瘤21例，去分化脂肪肉瘤24例。不典型脂肪瘤伴多形性脂肪肉瘤(n=1)。术语“细胞非典型脂肪瘤性肿瘤”是指非典型脂肪瘤性肿瘤，当非促脂肪细胞缺乏去分化成分所需的每10个高倍视野(最大比率)5个有丝分裂图形时，以及当促脂肪细胞肿瘤不是真正的多形性脂肪肉瘤时，其细胞密度增加的区域。光谱内的粘液样区域有时有明显的甚至丛状血管，特别是当存在散布的小脂肪细胞时，更类似于粘液样脂肪肉瘤。影响预后的最重要因素是肿瘤部位。因为12例皮下或肌肉内肿瘤患者无一例死于肿瘤。49例中心体部位肿瘤患者中，去分化脂肪肉瘤患者的生存期(中位数77mo)明显短于细胞性非典型脂肪瘤患者(中位数142mo)和常规非典型脂肪瘤患者(中位数209mo)，而后两类患者的生存期差异无统计学意义。中枢部位非典型脂肪瘤(无论是细胞性还是传统性)患者复发后转化为去分化脂肪肉瘤，生存期显著缩短；反之，中枢部位去分化脂肪肉瘤复发为非典型脂肪瘤患者生存期显著延长。转移(7例)仅在初始标本或复发标本显示去分化脂肪肉瘤时发生。
Sixty-one cases of neoplasms composed wholly or in part of atypical lipomatous tumor were reviewed. Minimum follow-up was 10 years. The cases were divided into 4 groups based on the findings in the initial excision specimen: conventional atypical lipomatous tumor (n = 15), cellular atypical lipomatous tumor (n = 21), dedifferentiated liposarcoma (n = 24). and atypical lipomatous tumor with a pleomorphic liposarcomalike component (n = 1). The term "cellular atypical lipomatous tumor" was applied to atypical lipomatous tumors having areas of increased cellularity that when nonlipogenic lacked the 5 mitotic figures per 10 high-power fields (maximal rate) required for a dedifferentiated component and when lipogenic fell short of being truly pleomorphic liposarcomalike. Myxoid regions within this spectrum sometimes had prominent or even plexiform vascularity, creating a resemblance to myxoid liposarcoma especially when interspersed small fat cells were present. The most important prognostic factor was tumor location. as none of the 12 patients with a subcutaneous or intramuscular neoplasm died of tumor. Among the 49 patients with neoplasms of central body sites (mostly retroperitoneum), those with dedifferentiated liposarcoma had significantly shorter survival (median 77 me) than those with cellular (median 142 mo) or conventional (median 209 mo) atypical lipomatous tumor, whereas there was no statistically significant difference between the latter 2 categories. Patients with atypical lipomatous tumor (either cellular or conventional) in central body sites had significantly shorter survival if the tumor transformed into dedifferentiated liposarcoma in recurrence, and, conversely, those with central body site dedifferentiated liposarcoma had significantly longer survival if it recurred as atypical lipomatous tumor. Metastasis (7 cases) occurred only when the initial specimen or a recurrence demonstrated dedifferentiated liposarcoma.