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Tumoren mit prädominant adipozytärer Morphologie

Tumors with predominantly adipocytic morphology

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Zusammenfassung

Mehr als 20 % aller Weichgewebstumoren gehören zur Gruppe adipozytärer Neoplasien. Schwierigkeiten bestehen bei dieser Tumorgruppe vor allem in der Abgrenzung zwischen gutartigem Lipom und atypischem lipomatösem Tumor/hoch differenziertem Liposarkom, in der Differenzialdiagnose zwischen dedifferenzierten Liposarkomen und anderen Weichgewebssarkomen sowie in der Zuordnung der verschiedenen Liposarkomsubtypen. Insbesondere an bioptischem Material können die korrekte Subtypisierung und das Grading bei limitiertem Probenumfang erschwert sein. Aufgrund des stetig steigenden molekularpathologischen Verständnisses von Weichgewebstumoren und der zugleich zunehmenden Verbreitung entsprechender molekularpathologischer Untersuchungsmethoden in pathologischen Instituten wird die Differenzialdiagnose erleichtert, da über 90 % der adipozytären Tumoren durch mehr oder weniger spezifische genomische Alterationen gekennzeichnet sind. Im folgenden Text werden die Hauptgruppen der adipozytären Tumoren erläutert und ihre morphologischen und molekularpathologischen Charakteristika dargestellt.

Abstract

More than 20% of soft-tissue tumors belong to the group of adipocytic neoplasms. Difficulties may occur in the differential diagnosis of lipomas versus atypical lipomatous tumors/well-differentiated liposarcomas, in the distinction of dedifferentiated liposarcomas from other soft-tissue sarcoma entities and in the detailed subtyping of liposarcomas. Especially in biopsies, the correct diagnosis and grading may be hampered due to limited tissue. Because of the ever-increasing molecular-pathological knowledge of soft-tissue tumors and the rising distribution of molecular diagnostic assays in institutes of pathology, differential diagnosis has been facilitated, as more than 90% of adipocytic tumors carry more or less specific genomic alterations. In the following, the most important subtypes of adipocytic tumors are described morphologically and genomically.

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Authors and Affiliations

  1. Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude D17, 48149, Münster, Deutschland

    E. Wardelmann & W. Hartmann

  2. Sektion für Translationale Pathologie, Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Münster, Deutschland

    W. Hartmann

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E. Wardelmann und W. Hartmann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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M. Evert, Regensburg

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Wardelmann, E., Hartmann, W. Tumoren mit prädominant adipozytärer Morphologie. Pathologe 40, 339–352 (2019). https://doi.org/10.1007/s00292-019-0624-1

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