Abstract：
Pleomorphic liposarcoma (PLPS) is the least common but most aggressive of all forms of liposarcoma (LPS). Its diagnosis relies on the recognition of pleomorphic lipoblasts (PLBs), whose numbers vary considerably. Because few large fine-needle aspiration (FNA) biopsy studies exist, the authors review their experience with PLPS.
The authors\' cytopathology files were searched for PLPS with histopathologic verification. FNA biopsy smears were performed via standard techniques.
Twenty cases from 20 patients (male/female ratio, 2.3/1; age range, 22-77 years; mean age, 58 years) met the inclusion criteria. All had tissue confirmation. Biopsy sites included the following: thigh (11 [55%]), upper extremity (4 [20%]), axilla (2 [10%]), neck (1 [5%]), chest wall (1 [5%]), and mediastinum (1 [5%]). Aspirates were from primary (17 [85%]), locally recurrent (2 [10%]), and metastatic neoplasms (1 [5%]). The FNA diagnoses were PLPS (10 [50%]), myxofibrosarcoma (4 [20%]), LPS (2 [10%]), sarcoma (2 [10%]), and high-grade malignant neoplasm (2 [10%]). Smears showed thick cell clusters and dissociated single forms. Pleomorphic, epithelioid, and bizarre cell/nuclear shapes were common. PLBs were absent, rare, or unnoticed in 45%. In 25%, smears dominated by myxoid stroma were diagnosed as high-grade myxofibrosarcoma or myxoid LPS. Ancillary testing performed in 5 cases had limited diagnostic efficacy.
FNA biopsy of PLPS, although able to successfully recognize malignancy, suffers from a sampling bias due to an inability to capture or recognize PLBs in a significant proportion of cases secondary to the heterogeneous composition of this neoplasm.
The authors\' cytopathology files were searched for PLPS with histopathologic verification. FNA biopsy smears were performed via standard techniques.
Twenty cases from 20 patients (male/female ratio, 2.3/1; age range, 22-77 years; mean age, 58 years) met the inclusion criteria. All had tissue confirmation. Biopsy sites included the following: thigh (11 [55%]), upper extremity (4 [20%]), axilla (2 [10%]), neck (1 [5%]), chest wall (1 [5%]), and mediastinum (1 [5%]). Aspirates were from primary (17 [85%]), locally recurrent (2 [10%]), and metastatic neoplasms (1 [5%]). The FNA diagnoses were PLPS (10 [50%]), myxofibrosarcoma (4 [20%]), LPS (2 [10%]), sarcoma (2 [10%]), and high-grade malignant neoplasm (2 [10%]). Smears showed thick cell clusters and dissociated single forms. Pleomorphic, epithelioid, and bizarre cell/nuclear shapes were common. PLBs were absent, rare, or unnoticed in 45%. In 25%, smears dominated by myxoid stroma were diagnosed as high-grade myxofibrosarcoma or myxoid LPS. Ancillary testing performed in 5 cases had limited diagnostic efficacy.
FNA biopsy of PLPS, although able to successfully recognize malignancy, suffers from a sampling bias due to an inability to capture or recognize PLBs in a significant proportion of cases secondary to the heterogeneous composition of this neoplasm.
摘要：
多形性脂肪肉瘤（PLPS）是所有形式的脂肪肉瘤（LPS）中最不常见但最具侵袭性的。它的诊断依赖于多形性成纤维细胞（PLB）的识别，他们的数字差异很大。因为很少有大型细针穿刺（FNA）活检研究存在，作者回顾了他们在PLPS方面的经验。
在作者的细胞病理学文件中搜索具有组织病理学验证的PLPS。通过标准技术进行FNA活检涂片。
20例患者中的20例（男女比例，2.3/1；年龄范围，22-77岁；平均年龄，58年)符合纳入标准。都有组织确认。活检部位包括：大腿（11[55%]），上肢（4[20%]），腋窝（2[10%]），颈部（1[5%]），胸壁（1[5%]），和纵隔（1[5%]）。吸入剂来自初级(17[85%])，局部复发（2[10%]），和转移性肿瘤（1[5%]）。FNA诊断为PLPS（10[50%]），粘液纤维肉瘤（4[20%]），LPS（2[10%]），肉瘤（2[10%]），和高级别恶性肿瘤（2[10%]）。涂片显示厚细胞簇和解离的单一形式。多态,上皮样，奇怪的细胞/核形状很常见。PLB缺席，罕见,或未被注意到的45%。在25%，以粘液样基质为主的涂片被诊断为高级别粘液纤维肉瘤或粘液样LPS。在5例中进行的辅助测试诊断功效有限。
PLPS的FNA活检，尽管能够成功识别恶性肿瘤，由于无法捕获或识别PLB，因此在很大一部分继发于该肿瘤异质组成的病例中，存在采样偏差。
在作者的细胞病理学文件中搜索具有组织病理学验证的PLPS。通过标准技术进行FNA活检涂片。
20例患者中的20例（男女比例，2.3/1；年龄范围，22-77岁；平均年龄，58年)符合纳入标准。都有组织确认。活检部位包括：大腿（11[55%]），上肢（4[20%]），腋窝（2[10%]），颈部（1[5%]），胸壁（1[5%]），和纵隔（1[5%]）。吸入剂来自初级(17[85%])，局部复发（2[10%]），和转移性肿瘤（1[5%]）。FNA诊断为PLPS（10[50%]），粘液纤维肉瘤（4[20%]），LPS（2[10%]），肉瘤（2[10%]），和高级别恶性肿瘤（2[10%]）。涂片显示厚细胞簇和解离的单一形式。多态,上皮样，奇怪的细胞/核形状很常见。PLB缺席，罕见,或未被注意到的45%。在25%，以粘液样基质为主的涂片被诊断为高级别粘液纤维肉瘤或粘液样LPS。在5例中进行的辅助测试诊断功效有限。
PLPS的FNA活检，尽管能够成功识别恶性肿瘤，由于无法捕获或识别PLB，因此在很大一部分继发于该肿瘤异质组成的病例中，存在采样偏差。
