HISTOPATHOLOGY

MACROSCOPIC
Right neck plus mediastinal mass: A smooth encapsulated, lobulated mass is inked with silver nitrate and serially sliced. The cut surface is yellow tan, soft and lobulated. Areas of haemorrhage or necrosis are not seen. Involvement of the capsule macroscopically is not identified.


MICROSCOPIC
Sections of demonstrate a tumour composed predominantly of adipocytes. Throughout the tumour there are background areas of fibrosis and collagen,scattered within which there are atypical cells. The atypical cells are characterised by nuclear enlargement and irregularity and some multinucleate forms are identified. These cells have a small amount of ampophilic cytoplasm, with no striations evident.  The mitotic rate is not elevated.  Rare lipoblasts are present. Immunoperoxidase staining is negative for actin and desmin and shows patchy positivity with CD34.


DIAGNOSIS: Well-differentiated liposarcoma (lipoma-like).

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