Diagnosing paediatric mediastinal lipoblastoma using ultrasound-guided percutaneous needle biopsy: Review and report
Introduction
Lipoblastoma is a rare tumor accounting to less than 1% of all childhood neoplasm [1], [2]; they are rarer still in the mediastinum, where less than 20 cases have been reported so far in the Western literature [1], [2], [3], [4], [5], [6], [7], [8]. It is well known as a benign mesenchymal tumour of embryonal adipose tissues with good prognosis despite propensity to local invasion and rapid growth. The usual imaging features of mediastinal lipoblastoma are either circumscribed or infiltrative mass with adipose tissues, which can masquerade as germ cell tumours or myxoid variant of liposarcoma in childhood. Previously, thoracotomy was often indicated in most of the cases in reaching a definitive diagnosis [2], [3]. The role of ultrasound (US)-guided needle biopsy was not mentioned. We herein present a case of mediastinal lipoblastoma diagnosed preoperatively by percutaneous transthoracic US-guided needle. The interactive roles of US in lesion localization and guidance for percutaneous needle biopsy were described. Differentiating this rare benign paediatric tumour from other mediastinal lesions is essential since there is a difference in surgical planning and prognosis.
Section snippets
Case report
A 3-year-old Chinese girl was referred to our institution for symptoms of upper respiratory tract infection and incidentally discovered right chest mass on plain radiograph. Her birth and development had been normal. This cheerful girl had no stridor. She was not tachypneic, but the breath sounds over the right chest were diminished. Laboratory examination findings, including measurement of serum alpha-fetalprotein, beta-human chorionic gonadotropin and 24-h urine vanillylmandelic acid levels,
Discussion
“Lipoblastoma” was first named by Jaffe in 1926 when he examined an immature fatty tumour [1], [9]. However, it was not until 1958 when Vellios et al. successfully categorized it as a distinct histopathologic entity when they described the diffuse form, lipoblastomosis, in the axillary and supraclavicular regions [1], [2], [9]. It is characterized by distinct histologic hallmark of clusters of mature adipocytes in the central lobules separated by fibrous septa and surrounded by immature
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