PMC9883842_01
Lumbar MRI scan revealed a well-defined lesion (see the star in the image) at the left L1-L3 paraspinal area on T2-weighted image (A) with heterogenous enhancement (B). Postoperative MRI revealed total tumor removal (C). Pathology proved an atypical spindle cell lipomatous tumor.
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The mass extended from L1 to L3 over L1 and L2 neuroforamen (Figure 1A,B). Postoperative MRI confirmed the total removal of the tumor (Figure 1C).
Pathology of resected atypical spindle cell lipomatous tumor showed increased cellularity of proliferative spindle cell components with minimal nuclear atypia and admixed adipocytic cells in the fibromyxoid stroma with stout ropy collagen fibers. Tumor cells demonstrated positive reactivity with CD34 and Rb. (A) Hematoxylin and eosin (H&E) stain, x100, (B) H&E, x200, (C) CD34, x100, (D) RB, x200.
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Permanent tissue analysis of the specimen (hematoxylin and eosin) revealed increased cellularity of proliferative spindle cell components with minimal nuclear atypia and admixed adipocytic cells, including scant lipoblasts, in the fibromyxoid stroma with stout ropy collagen fibers (Figure 2A,B). Immunohistochemistry (IHC) showed the neoplastic cells to be positive for CD34 and p16 (focal) but negative for MDM2, CDK4, S100, and desmin (Figure 2C). The Rb expression was reduced to absent (Figure 2D), and p53 revealed wild-type expression.