Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction
Pleomorphic liposarcoma (PLS) is typically found in the lower and upper extremities. PLS arising in the gastrointestinal (GI) tract is extremely rare. Here, we reported a case of a 71-year-old female with a history of rectal adenocarcinoma presenting with small bowel obstruction. Small bowel resecti...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Hindawi Limited
2023-01-01
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| Series: | Case Reports in Pathology |
| Online Access: | http://dx.doi.org/10.1155/2023/8040232 |
| _version_ | 1826993207492214784 |
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| author | Mohammad Al-Attar Anup Jnawali Michelle Yang |
| author_facet | Mohammad Al-Attar Anup Jnawali Michelle Yang |
| author_sort | Mohammad Al-Attar |
| collection | DOAJ |
| description | Pleomorphic liposarcoma (PLS) is typically found in the lower and upper extremities. PLS arising in the gastrointestinal (GI) tract is extremely rare. Here, we reported a case of a 71-year-old female with a history of rectal adenocarcinoma presenting with small bowel obstruction. Small bowel resection was performed and revealed a 7.8 cm transmural mass in the jejunum. Histology reviewed a heterogenous epithelioid malignant tumor with intracytoplasmic fatty droplets scalloping the nucleus consistent with lipoblasts in some cells and others with numerous PAS/diastase+intracytoplasmic eosinophilic globules. Scattered multinucleated giant cells were also present. Mitotic count was up to 80/10 HPFs including some bizarre mitotic figures, and Ki67 proliferation index was approximately 60%. Immunohistochemistry demonstrated that the malignant cells were negative for pancytokeratin, CD117, DOG1, SMA, desmin, MyoD1, ERG1, CD34, CD31, SOX10, Melan A, and S100. INI1 was retained. Beta-catenin showed normal membranous staining. P53 was diffusely positive suggestive of mutant phenotype. Fluorescence in situ hybridization (FISH) assay was negative for MDM2 amplification and DDIT3 rearrangement. The overall morphologic and immunohistochemical features supported a diagnosis of high-grade pleomorphic liposarcoma. Diagnosis of PLS can be challenging due to its rarity in GI tract and lack of specific biomarkers, and histomorphology with identification of lipoblasts remains the gold standard. |
| first_indexed | 2024-03-13T01:21:00Z |
| format | Article |
| id | doaj.art-0d4567799a9e42aaa3d7816b72d44ba7 |
| institution | Directory Open Access Journal |
| issn | 2090-679X |
| language | English |
| last_indexed | 2025-02-18T09:00:28Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Case Reports in Pathology |
| spelling | doaj.art-0d4567799a9e42aaa3d7816b72d44ba72024-11-02T23:52:56ZengHindawi LimitedCase Reports in Pathology2090-679X2023-01-01202310.1155/2023/8040232Rare Pleomorphic Liposarcoma Presented as Jejunal ObstructionMohammad Al-Attar0Anup Jnawali1Michelle Yang2University of Massachusetts Memorial Health CareUniversity of Massachusetts Memorial Health CareUniversity of Massachusetts Memorial Health CarePleomorphic liposarcoma (PLS) is typically found in the lower and upper extremities. PLS arising in the gastrointestinal (GI) tract is extremely rare. Here, we reported a case of a 71-year-old female with a history of rectal adenocarcinoma presenting with small bowel obstruction. Small bowel resection was performed and revealed a 7.8 cm transmural mass in the jejunum. Histology reviewed a heterogenous epithelioid malignant tumor with intracytoplasmic fatty droplets scalloping the nucleus consistent with lipoblasts in some cells and others with numerous PAS/diastase+intracytoplasmic eosinophilic globules. Scattered multinucleated giant cells were also present. Mitotic count was up to 80/10 HPFs including some bizarre mitotic figures, and Ki67 proliferation index was approximately 60%. Immunohistochemistry demonstrated that the malignant cells were negative for pancytokeratin, CD117, DOG1, SMA, desmin, MyoD1, ERG1, CD34, CD31, SOX10, Melan A, and S100. INI1 was retained. Beta-catenin showed normal membranous staining. P53 was diffusely positive suggestive of mutant phenotype. Fluorescence in situ hybridization (FISH) assay was negative for MDM2 amplification and DDIT3 rearrangement. The overall morphologic and immunohistochemical features supported a diagnosis of high-grade pleomorphic liposarcoma. Diagnosis of PLS can be challenging due to its rarity in GI tract and lack of specific biomarkers, and histomorphology with identification of lipoblasts remains the gold standard.http://dx.doi.org/10.1155/2023/8040232 |
| spellingShingle | Mohammad Al-Attar Anup Jnawali Michelle Yang Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction Case Reports in Pathology |
| title | Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction |
| title_full | Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction |
| title_fullStr | Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction |
| title_full_unstemmed | Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction |
| title_short | Rare Pleomorphic Liposarcoma Presented as Jejunal Obstruction |
| title_sort | rare pleomorphic liposarcoma presented as jejunal obstruction |
| url | http://dx.doi.org/10.1155/2023/8040232 |
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