Home | About us | Editorial Board | Search | Ahead of print | Current Issue | Archives | Instructions | Online submissionContact Us   |  Subscribe   |  Advertise   |  Login  Page layout
Wide layoutNarrow layoutFull screen layout
Lung India Official publication of Indian Chest Society  
  Users Online: 1295   Home Print this page  Email this page Small font size Default font size Increase font size


 
  Table of Contents    
LETTERS TO EDITOR
Year : 2018  |  Volume : 35  |  Issue : 2  |  Page : 186-187  

Intrathoracic liposarcoma: Case report with emphasis to histogenesis and site of origin classification problems


1 Provincial Health Care Services, Institute of Anatomic Pathology, Santa Maria del Carmine Hospital, 38100 Rovereto (TN), Italy
2 Department of Radiology, Budrio Hospital, 40054 Budrio (BO), Italy
3 Department of Surgical and Biomedical Sciences, Division of Radiology and Nuclear Medicine, S.M. Della Misericordia Hospital, 06156 Perugia, Italy

Date of Web Publication27-Feb-2018

Correspondence Address:
Prof. Michele Scialpi
Department of Surgical and Biomedical Sciences, Division of Radiology and Nuclear Medicine, S.M. Della Misericordia Hospital, 06156 Perugia
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/lungindia.lungindia_332_17

Rights and Permissions

How to cite this article:
Pusiol T, Piscioli I, Rondoni V, Scialpi M. Intrathoracic liposarcoma: Case report with emphasis to histogenesis and site of origin classification problems. Lung India 2018;35:186-7

How to cite this URL:
Pusiol T, Piscioli I, Rondoni V, Scialpi M. Intrathoracic liposarcoma: Case report with emphasis to histogenesis and site of origin classification problems. Lung India [serial online] 2018 [cited 2020 Sep 30];35:186-7. Available from: http://www.lungindia.com/text.asp?2018/35/2/186/226214



Sir,

Intrathoracic liposarcoma (IL) may arise from mediastinum, lung, and pleural cavity. In these sites, the tumor may remain limited to the origin site or infiltrate the adjacent organs. In all origin sites, the L originates from primitive mesenchymal cells, localized in the endothoracic fascia (lung L),[1] present in the submesothelial tissue of parietal pleura (pleural L), or disseminated in the mediastinum (mediastinal L).

In the present case of voluminous IL, we discuss the radiological features with emphasis to histogenesis and location classification problems.

A 46-year-old man presented with a 2-month history of chest distress and persistent subdiaphragmatic pain.

Chest X-ray showed extensive opacity of the left hemithorax [Figure 1]a corresponding to adipose tissue with dense striae and lobulation on axial [Figure 1]b and coronal multiplanar reconstruction [Figure 1]c computed tomography. The left lung was collapsed and compressed medially.
Figure 1: Chest X-ray showed extensive opacity of the left hemithorax (a) corresponding to adipose tissue with dense striae and lobulation on axial (b) and coronal multiplanar reconstruction (c) computed tomography. Note the left lung collapsed and compressed medially (b)

Click here to view


Because a complete excision was not possible, thoracoscopic biopsy was performed. The tissue fragment revealed myxoid L [Figure 2].
Figure 2: The tumor showed areas characterized by small, round to oval cells, embedded in abundant myxoid stroma and displaying a delicate arborizing capillary vascular network (H and E, ×40)

Click here to view


The present case demonstrated the decisive role of the imaging in the establishing nature of intrathoracic tumors, supported by biopsy procedures[2] with therapeutic implications. In the study of IL, it is essential to establish the histological subtype. The myxoid L is highly radiosensitive and remarkable response has been reported, with volume reduction of 52%, lipoma-like transformation and dense vascular pattern.[3] Radiotherapy is believed to be an ineffective therapeutic modality for survival of dedifferentiated and pleomorphic subtypes. According to the classification of tumor location, the terms mediastinal, lung, or pleural L may be used exclusively for the tumor limited to origin site. When L extends to two or all intrathoracic locations, the term IL is more appropriate. The accurate description of the tumor extension should be described in the report. Because of the expansile rather than infiltrative growth pattern of myxoid L, patients often present with few symptoms despite having large or even massive tumor.[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Roncati L, Pusiol T, Scialpi M. The endothoracic fascia: An anatomic site in which primary liposarcoma may arise. Lung 2015;193:1055-6.  Back to cited text no. 1
    
2.
Pusiol T, Scialpi M. Role of computed tomography in the preoperative diagnosis of giant benign solitary fibrous tumor pleura. Lung India 2013;30:82-5.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Engström K, Bergh P, Cederlund CG, Hultborn R, Willen H, Aman P, et al. Irradiation of myxoid/round cell liposarcoma induces volume reduction and lipoma-like morphology. Acta Oncol 2007;46:838-45.  Back to cited text no. 3
    
4.
Chen M, Yang J, Zhu L, Zhou C, Zhao H. Primary intrathoracic liposarcoma: A clinicopathologic study and prognostic analysis of 23 cases. J Cardiothorac Surg 2014;9:119.  Back to cited text no. 4
[PUBMED]    


    Figures

  [Figure 1], [Figure 2]



 

Top
  
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed920    
    Printed7    
    Emailed0    
    PDF Downloaded91    
    Comments [Add]    

Recommend this journal