Lipoblastoma : Differential Diagnosis

Comments:
Differential Diagnosis: The main differential diagnostic consideration is myxoid liposarcoma (LPS). Lipoblastoma resembles myxoid LPS due to the presence of lipoblasts, plexiform vascular channels, and myxoid stroma.

Features favoring lipoblastoma: young age of the patient (90% of patients younger than 3 yrs.), lobular architecture, maturation towards the periphery of lobules, absence of nuclear hyperchromasia, and rearrangement of 8q11-q13 region involving the PLAG1 gene.

Features favoring myxoid LPS: older patient (peak incidence in 3rd to 6th decades); myxoid LPS of children usually occurs in children > 5 years of age; nuclear atypia or hyperchromasia at least focally; hypercellularity; microcystic spaces with pooling of mucin; characteristic translocation t(12;16)(q13;p11) involving the DDIT3 and FUS genes.

Other entities that may need to be ruled out include lipoma, fibrolipoma and infantile fibromatosis.