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Utility of fluorescence in situ hybridization to detect MDM2 amplification in liposarcomas and their morphological mimics.
[well-differentiated liposarcoma]
The
atypical
lipomatous
tumor
(
ALT
)
/
well-differentiated
liposarcoma
(
WDLS
)
and
the
de
-differentiated
liposarcoma
(
DDLS
)
represent
the
most
common
category
of
liposarcomas
.
ALT
/
WDLSs
and
DDLSs
are
often
difficult
to
distinguish
from
other
tumors
with
similar
morphological
characteristics
.
In
this
study
,
we
investigated
whether
the
detection
of
amplified
or
overexpressed
murine
double
-
minute
2
(
MDM
2
)
can
be
a
useful
diagnostic
ancillary
aid
.
We
used
fluorescent
in
situ
hybridization
(
FISH
)
and
immunohistochemistry
(
IHC
)
to
detect
MDM
2
amplification
and
protein
overexpression
,
respectively
,
in
49
WDLSs
,
5
DDLSs
,
23
myxoid
liposarcomas
,
25
benign
lipomatous
tumors
,
and
75
spindle
and
pleomorphic
sarcomas
.
MDM
2
amplification
was
detected
in
48
of
49
WDLSs
,
5
of
5
DDLSs
,
2
of
9
malignant
peripheral
nerve
sheath
tumors
,
and
2
of
10
myxofibrosarcomas
.
We
did
not
detect
MDM
2
amplification
in
any
of
the
benign
lipomatous
tumors
.
FISH-mediated
detection
of
MDM
2
amplification
was
the
most
valuable
diagnostic
aid
for
ALT
/
WDLS
,
as
determined
by
using
the
Fisher
exact
test
to
compare
two
different
diagnoses
of
19
biopsies
.
On
the
contrary
,
unequivocal
nuclear
overexpression
of
MDM
2
was
found
in
only
10
of
50
ALT
/
WDLSs
.
The
sensitivity
and
specificity
of
MDM
2
amplification
in
distinguishing
a
DDLS
from
spindle
and
pleomorphic
sarcomas
were
100
%
and
95
%
,
respectively
,
while
those
of
MDM
2
overexpression
were
100
%
and
87
%
,
respectively
.
In
conclusion
,
our
results
indicate
that
FISH-mediated
detection
of
MDM
2
amplification
is
the
most
useful
adjunct
in
the
diagnosis
of
both
ALT
/
WDLS
and
DDLS
.
However
,
IHC-mediated
detection
of
MDM
2
protein
is
useful
only
for
the
diagnosis
of
DDLS
.
Diseases
Validation
Diseases presenting
"and 75 spindle and pleomorphic sarcomas"
symptom
well-differentiated liposarcoma
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