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Cytogenetics is of considerable value when diagnosing lipomatous tumours, as different tumour types have different more or less specific chromosomal abnormalities. One such entity is lipoblastoma, which is a benign lipomatous tumour that often exhibits rearrangements of chromosome bands 8q11–13, and the genePLAG1has been implicated as the target of these chromosomal changes. All lipomatous tumours karyotyped at the Norwegian Radium Hospital were reviewed, looking for rearrangements of 8q11–13. Five tumours exhibiting chromosomal abnormalities affecting this region were found. Only one of them was morphologically diagnosed as a lipoblastoma, two being classified as lipomas, one as a hibernoma, and one as a well-differentiated liposarcoma. The two tumours successfully analysed with bacterial artificial chromosomes (BACs) covering the genePLAG1showed involvement of this gene in the rearrangement. The findings raise the question as to what extent the diagnosis lipoblastoma should be based on histopathological or cytogenetic/molecular data or a combination thereof. When karyotypic information from this series was combined with available literature data, it was found that the sensitivity of 8q11–13 rearrangements for diagnosing lipoblastomas when found in a lipomatous tumour was 77% and that the corresponding specificity was 98%. The validity of these calculations of the diagnostic information provided by the cytogenetic findings is, of course, totally dependent on the morphological diagnosis made in each case. Regardless of what the precise phenotypic diagnosis was, it is suggested that lipomatous tumours with 8q11–13 rearrangement constitute a distinct pathogenetic entity. When selective therapies tailor-made against the specific pathogenetic rearrangement become available, it will become mandatory to pay more attention to the genetic constitution of the tumour cells than to their phenotypic appearance. Copyright © 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.