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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.
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.