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Presented by Pedram Argani, M.D. and prepared by Wang (Steve) Cheung, M.D., Ph.D.
Case 2: 58 year old male with a mass involving the renal capsule and peri-renal soft tissue.
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1. Question
Week 347: Case 2
58 year old male with a mass involving the renal capsule and peri-renal soft tissue/images/470802a.jpg
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Answer: Liposarcoma, well-differentiated
Histology: This is a fatty lesion which abuts the renal capsule, but predominantly involves the peri- renal soft tissue. Within the fat, located within thin fibrous septa, are scattered cells with enlarged, hyperchromatic nuclei, diagnostic of lipoblasts. Cellular areas, or foci of increased mitotic activity, are not present in these sections.
Discussion: The current lesion lacks the dysplastic blood vessels of an angiomyolipoma, or evidence of a muscular component. Mixed epithelial stromal tumor (MEST) of the kidney may rarely contain predominantly adipose tissue and protrude into the peri-renal fat. However, MEST should not have the atypia present within a well-differentiated liposarcoma. A lipoma also would lack the atypia present in a well differentiated liposarcoma. Lipoma is a extremely rare in the retroperitoneum and peri-renal soft tissue.
Reference(s):
– Sireci N e al. Int J Surg Pathol 2008;16:73-77.Incorrect
Answer: Liposarcoma, well-differentiated
Histology: This is a fatty lesion which abuts the renal capsule, but predominantly involves the peri- renal soft tissue. Within the fat, located within thin fibrous septa, are scattered cells with enlarged, hyperchromatic nuclei, diagnostic of lipoblasts. Cellular areas, or foci of increased mitotic activity, are not present in these sections.
Discussion: The current lesion lacks the dysplastic blood vessels of an angiomyolipoma, or evidence of a muscular component. Mixed epithelial stromal tumor (MEST) of the kidney may rarely contain predominantly adipose tissue and protrude into the peri-renal fat. However, MEST should not have the atypia present within a well-differentiated liposarcoma. A lipoma also would lack the atypia present in a well differentiated liposarcoma. Lipoma is a extremely rare in the retroperitoneum and peri-renal soft tissue.
Reference(s):
– Sireci N e al. Int J Surg Pathol 2008;16:73-77.
