A Case of GATA3 Positive Pleomorphic Liposarcoma, Epithelioid Variant: A Diagnostic Pitfall.

IF 0.7 Q4 PATHOLOGY Case Reports in Pathology Pub Date : 2023-01-01 DOI:10.1155/2023/9443027
Makoto Abe, Nobuo Hoshi, Sayuri Hoshi, Kaoru Hirabayashi, Kazutaka Kikuta, Toru Hirozane, Rumi Nakagawa, Tsukasa Mizuno, Hiroshi Nakamura, Koichi Inoue, Takehiko Yamaguchi
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Abstract

Pleomorphic liposarcoma is a rare malignant adipocytic tumor showing undifferentiated pleomorphic sarcoma morphology with various degrees of epithelioid features. It is sometimes difficult to distinguish from carcinoma metastasis. Immunohistochemical panel is very important for differential diagnosis; however, there is a risk that unexpected staining could lead to misinterpretation. We report a pleomorphic liposarcoma, epithelioid variant, in an 88-year-old man, with tricky-positive staining for GATA3. Histological examination revealed a tumor with epithelioid morphology. The tumor consists of solid sheets of epithelioid tumor cells with focal aggregates of pleomorphic lipoblasts. Immunohistochemically, the adipocytic tumor cell areas were positive for S100 protein, and the epithelioid tumor cells showed CAM 5.2 positivity. GATA3 was diffusely positive. The combination of CAM 5.2 and GATA3 staining suggested the possibility of metastatic cancer, but systemic clinical examinations did not detect any presence of a primary tumor, including urinary bladder, breasts, and salivary glands. The pathological diagnosis of pleomorphic liposarcoma, epithelioid variant, was made because of the presence of malignant lipoblasts. Our report may contribute for differential diagnosis of pleomorphic liposarcoma, epithelioid variant, with unexpected positive immunoreaction for GATA3.

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GATA3阳性多形性脂肪肉瘤1例,上皮样变异:一个诊断缺陷。
多形性脂肪肉瘤是一种罕见的恶性脂肪细胞肿瘤,表现为未分化的多形性肉瘤,具有不同程度的上皮样特征。有时很难与癌转移区分开。免疫组化检查对鉴别诊断有重要意义;然而,意外染色有可能导致误解。我们报告一例多形性脂肪肉瘤,上皮样变异型,患者为88岁男性,GATA3染色呈阳性。组织学检查显示肿瘤呈上皮样形态。肿瘤由实体上皮样肿瘤细胞片和局灶性多形性脂肪母细胞聚集体组成。免疫组化结果显示,脂肪细胞区S100蛋白阳性,上皮样肿瘤细胞CAM 5.2阳性。GATA3呈弥漫性阳性。CAM 5.2和GATA3染色提示转移癌的可能性,但系统临床检查未发现原发性肿瘤的存在,包括膀胱、乳房和唾液腺。病理诊断为多形性脂肪肉瘤,上皮样变异,因为存在恶性脂肪母细胞。我们的报告可能有助于鉴别诊断多形性脂肪肉瘤,上皮样变异,意外的GATA3阳性免疫反应。
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审稿时长
12 weeks
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