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Soft Tissue Pathology 

Pathology of Lipomatous Hemangiopericytoma

(Fat forming solitary fibrous tumor)

Dr Sampurna Roy MD

 

                                                                                                                      

 

 

Lipomatous hemangiopericytoma, a rare soft tissue tumour with unpredictable biologic behavior, was reported in 1995 by Nielsen et al.

The tumour shows clinical, pathologic, immunohistochemical, and ultrastructural features of a solitary fibrous tumour and probably represent, in most cases, a fat-containing variant of solitary fibrous tumour.

Age:

Usually occurs in middle-aged patients. (mean age 54 years)

Site:

The locations included the sinonasal area, orbit , neck, mediastinum, epicardium, soft tissue of the shoulder and the retroperitoneum, right iliac fossa ,upper and lower extremity.

Gross feature:

The tumour usually ranges in size from 4 to 10 cm in greatest diameter.

Macroscopically, it is a solid mass with a tan to yellow cut surface.

Microscopic features: 

Histopathology Image 1 ; Histopathology Image2  ; Histopathology Image3

The tumour has a relatively sharp border and is composed of a variable admixture of benign lipomatous and hemangiopericytomatous components.

The hemangiopericytomatous component included oval to round cells surrounding a sinusoidal and staghorn vasculature often with perivascular hyalinization.

Mature fat varied in amount but usually occupied approximately one quarter to three quarters of the area of tumour. 

The mitotic activity usually ranged from 1 to 3 mitoses per 10 high-power fields (HPF).

In one case, many multivacuolated adipocytes of variable size with characteristic nuclear scalloping (lipoblast-like cells) are present.

Immunohistochemistry:

 The tumour stained with antibodies to vimentin and not to alpha-smooth-muscle actin, muscle-specific actin, desmin, S-100 protein, glial fibrillary acidic protein, epithelial membrane antigen  or keratin.

Differential diagnosis :    

Spindle cell neoplasms mixed with adipose tissue include-  Extrathoracic solitary fibrous tumours ;  Cellular angiofibroma ; Spindle cell lipoma ; Dendritic fibromyxolipoma.

Angiolipoma   Liposarcoma ;  Tumours showing smooth muscle and adipocytic differentiation ;  Hemangiopericytoma infiltrating fat.

 

Further reading:

Lipomatous hemangiopericytoma (adipocytic variant of solitary fibrous tumor) of the parotid gland: A case report and review of the literature.

Malignant fat-forming solitary fibrous tumor (lipomatous hemangiopericytoma) in the neck: Imaging and histopathological findings of a case.

Rare case of paratesticular solitary fibrous tumour (lipomatous hemangiopericytoma).

Lipomatous hemangiopericytoma of the stomach: a case report and a review of literature.

Malignant fat-forming solitary fibrous tumor (so-called "lipomatous hemangiopericytoma"): clinicopathologic analysis of 14 cases.

Fat-forming solitary fibrous tumour (lipomatous haemangiopericytoma) of the spine: case report and literature review.

Fat-forming variant of solitary fibrous tumour of the orbit: the entity previously known as lipomatous haemangiopericytoma.

Fat-containing variant of solitary fibrous tumor (lipomatous hemangiopericytoma) arising on surface of kidney.

Fine-needle aspiration smears from lipomatous hemangiopericytoma need not be confused with myxoid liposarcoma.

Orbital lipomatous haemangiopericytoma: an unusual variant.

Lipomatous hemangiopericytoma: a fat-containing variant of solitary fibrous tumor? Clinicopathologic, immunohistochemical, and ultrastructural analysis of a series in favor of a unifying concept.

Lipomatous hemangiopericytoma: a morphologically distinct soft tissue tumor.

Lipomatous hemangiopericytoma: a rare variant of hemangiopericytoma that may be confused with liposarcoma.

Lipomatous hemangiopericytoma. A histologic, ultrastructural and immunohistochemical study of a unique variant of hemangiopericytoma.

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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