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 Path Case 2: Diagnosis- Pleomorphic Lipoma
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April 2008
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Spindle cell lipoma and pleomorphic lipoma occur in adults and are more common in males. These are located on the back of the neck, upper back or shoulders. These tumours usually present as a solitary, painless, slow growing, lobular mass with an average diameter of 5 cms. Rarely multiple lesions may develop. Cut surface has a yellow or grayish - yellow colour. Sometimes mucoid areas are present. Histological features of Spindle cell lipoma: This is a well circumscribed lesion usually confined to the subcutis. Some lesions are confined to the dermis (intradermal spindle cell lipoma). The tumour consists of an admixture of adipocytes and spindle cells. Spindle cells are arranged in short fascicles. The spindle cells are small and elongated and contain bland, uniform nuclei and pale eosinophilic cytoplasm. In areas nuclear palisading is present. The stroma is characterized by the presence of eosinophilic collagen fibres. Numerous mast cells are present. There is no increase in mitoses. Some cases show prominent myxoid changes. The adipocytes are mature . No lipoblasts are seen. In 'pseudoangiomatous variant' , irregular branching vascular channel together with villiform connective tissue projections are present.Pseudoangiomatous spindle cell lipoma with "true" angiomatous features.Virchows Arch. 2005 Oct;447(4):781-3. Epub 2005 Oct 19. Histological features of Pleomorphic lipoma : ImageLink (Dr Weems)
Image
Link1
This is a well circumscribed
tumour which is usually superficial in location. Differential diagnosis of spindle cell lipoma -
Schwannoma
and
neurofibroma
(Adipocytes absent, S100 protein positive ).
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