PMC3896736_01
Preoperative antero-posterior chest radiograph. Antero-posterior chest radiograph shows widened mediastinum and parenchymal haziness at the bases of both lungs.
1749-8090-9-6-1.jpg
PMC3896736_01_1749-8090-9-6-1.jpg
F1
Chest radiograph demonstrated a widened mediastinum and bilateral lower lobe haziness (Figure 1).
Preoperative computed tomography scan. Chest computed tomography scan at the level of pulmonary hilum (upper left image) demonstrates the multi-lobulated mass, well-defined, homogenous, low-attenuation mass in the anterior mediastinum. The other three images show lobulated mass with multiple calcific septations. The fat plane between the mass and the left pulmonary artery is focally obliterated.
1749-8090-9-6-2.jpg
PMC3896736_01_1749-8090-9-6-2.jpg
F2
The mass abutted the ascending aorta, pulomonary artery, right hemidiaphragm, and the pericardium with focal obliteration of fat planes (Figure 2).
Intraoperative photograph. Intraoperative specimen, liposarcoma appearance is similar to that of mature fat.
1749-8090-9-6-3.jpg
PMC3896736_01_1749-8090-9-6-3.jpg
F3
The tumor measured 36 x 20 x 6.5 cm and weighed 2930 g (Figure 3).
Histological sections. A, Adipose cells and fibrous strands with scattered "signet-ring" type cells resembling normal adipose tissue but with large, deep-stranding nuclei (hematoxylin-eosin, original magnification x 200). B, Lipoblast showing lipid vacuoles and indented nucleus (hematoxylin-eosin, original magnification x 400). C, Lochkern vacuole (hematoxylin-eosin, original magnification x 200).
1749-8090-9-6-4.jpg
PMC3896736_01_1749-8090-9-6-4.jpg
F4
Histologically, the tissue was composed of variable sized mature lipocytes (Figure 4A) with large sharply outlined vaculoles (Lochkern vacuoles), fibromyxoid stroma containing spindle cells (Figure 4C) and lipoblasts with mitotic rate of 1 to 3 per 10 high-power fields (Figure 4B).