Liposarcoma laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Overview

The definitive diagnosis of liposarcoma is made by biopsy, which also provides histopathological classification of the liposarcoma's subtype. Other pertinent laboratory finding include anemia and elevated BUN due to GI bleeding and elevated creatinine among patients with obstructive nephropathy.

Laboratory Findings

Biopsy

Although imaging may be helpful in the diagnosis of liposarcoma, the optimal method for diagnosis of liposarcoma is by biopsy. A biopsy also provides important histopathological information requires to identify the subtype of the liposarcoma.

Subtype	Findings
Atypical Lipomatous Neoplasm (ALN)/Well-Differentiated Liposarcoma (WDL)	4 subtypes: *Lipoma-like *Sclerosing *Spindle cell *Inflammatory Multivacuolated lipoblasts and spindle cells with hyperchromatic nuclei are often observed. Other findings include fibrotic areas and atypical stroma cells.
De-differentiated Liposarcoma	Abrupt transition from a low-grade to a high-grade differentiation within the same mass of a well-differentiated liposarcoma.
Myxoid liposarcoma	Multinodular mass with round cells and hyaluronic acid matrix. High cellularity at the periphery and low cellularity at the center of the mass. Mitotic activity is normal and the nuclei are normochromatic.
Pleomorphic liposarcoma	Pleomorphic lipoblasts with hyperchromatic nuclei, acidophilic cytoplasm, and eosinophilic hyaline globules. Spindle cells and multinucleated giant cells may be observed.
Mixed-type Liposarcoma	Mixed features of myxoid, pleomorphic, and well-differentiated liposarcoma.
Table adapted from Fletcher CDM, Unni KK, Mertens F, eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Geneva:IARC Press; 2002 and Enzinger and Weiss's Soft Tissue Tumors , 6th Edition

Well Differentiated Liposarcoma. Image courtesy of Wikimedia Commons.	Dedifferentiated Liposarcoma. Image courtesy of Wikimedia Commons.	Dedifferentiated Liposarcoma. Image courtesy of Wikimedia Commons.
Dedifferentiated Liposarcoma. Image courtesy of Wikimedia Commons.	Dedifferentiated Liposarcoma. Image courtesy of Wikimedia Commons.

Laboratory Tests

• There are no specific laboratory tests for the diagnosis of liposarcoma.
• Patients withureteral or renal involvement, an elevated creatinine may be observed.
• Anemia and elevated BUN may be present among patients with liposarcoma assoicated with GI bleeding.
• The level of D-dimer has been studied as a marker for the differential diagnosis of lipoma and well-differentiated liposarcoma. Results have demonstrated that liposarcoma may have increased levels of D-dimer compared to lipoma.