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]

Laboratory Findings

Biopsy

Although imaging assists in the diagnosis of liposarcoma, a biopsy is needed to confirm the disease and determine the histopathological subtype of liposarcoma.

Subtype	Findings
Atypical Lipomatous Neoplasm (ALN)/Well-Differentiated Liposarcoma (WDL)	4 subtypes: lipoma-like, sclerosing, spindle cell and inflammatory. Multivacuolated lipoblasts and spindle cells with a hyperchromatic nuclei. Fibrotic areas and atypical stroma cells may be observed.
Dedifferentiated Liposarcoma	Abrupt transition from a low-grade to a high-grade differentiation within the same mass of well-differentiated liposarcoma.
Myxoid Liposarcoma	Multinodular mass with round cells, hyaluronic acid matrix. High cellularity at the periphery and low cellularity inside the mass. Mitotic activity is normal and the nuclei is normochromatic.
Pleomorphic Liposarcoma	Pleomorphic lipoblasts with hyperchromatic nuclei, acidophilic cytoplasm and eosinophilic hyaline globules; spinde cells and multinucleated giant cells may be observed.
Mixed-type Liposarcoma	Mixed features of myxoid, pleomorphic and well-differentiated liposarcoma.
Table adapted from Fletcher C.D.M., Unni K.K., Mertens F. (Eds.): WHO Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone 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 test findings for the diagnosis of liposarcoma.
• In cases of ureter or kidney involvement, an elevated creatinine and BUN may be seen.
• Anemia may be present, specially if there is bleeding associated with the liposarcoma.
• The level of D-dimer has been studied as a marker for the differential diagnosis of lipoma and well-differentiated liposarcoma, the latter having higher levels of D=dimer.