Difference between revisions of "Adipocytic tumours"

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Adipocytic tumours (view source)

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===IHC===
===IHC===
*S100 +ve.
*[[S-100]] +ve.


==Lipoblastoma==
==Lipoblastoma==
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*[http://www.sarcomaimages.com/index.php?v=Lipoblastoma Lipoblastoma (sarcomaimages.com)].
*[http://www.sarcomaimages.com/index.php?v=Lipoblastoma Lipoblastoma (sarcomaimages.com)].


==Lipoma==
==Lipoblastoma like tumor==
{{Main|Lipoma}}


==Pleomorphic lipoma==
[[File: 5 22974716644038 sl 1.png|Lipoblastoma like tumor]]
===General===
[[File: 5 22974716644038 sl 2.png|Lipoblastoma like tumor]]
*Rare.
[[File: 5 22974716644038 sl 3.png|Lipoblastoma like tumor]]
*May mimic a malignancy.<ref name=pmid15510605>{{Cite journal  | last1 = Persichetti | first1 = P. | last2 = Di Lella | first2 = F. | last3 = Marangi | first3 = GF. | last4 = Cagli | first4 = B. | last5 = Simone | first5 = P. | last6 = Tenna | first6 = S. | last7 = Rabitri | first7 = C. | last8 = Cassandro | first8 = R. | last9 = Esposito | first9 = V. | title = Pleomorphic lipoma: a definite histopathological entity. | journal = Anticancer Res | volume = 24 | issue = 5B | pages = 3157-9 | month =  | year =  | doi =  | PMID = 15510605 }}</ref>
[[File: 5 22974716644038 sl 4.png|Lipoblastoma like tumor]]
*Male > female.<ref name=pmid18181679>{{Cite journal  | last1 = Syed | first1 = S. | last2 = Martin | first2 = AM. | last3 = Haupt | first3 = H. | last4 = Podolski | first4 = V. | last5 = Brooks | first5 = JJ. | title = Frequent detection of androgen receptors in spindle cell lipomas: an explanation for this lesion's male predominance? | journal = Arch Pathol Lab Med | volume = 132 | issue = 1 | pages = 81-3 | month = Jan | year = 2008 | doi = 10.1043/1543-2165(2008)132[81:FDOARI]2.0.CO;2 | PMID = 18181679 }}</ref>


===Gross===
*Classically shoulder and neck region in adults.<ref>URL: [http://www.webpathology.com/image.asp?n=2&Case=435 http://www.webpathology.com/image.asp?n=2&Case=435]. Accessed on: 3 October 2011.</ref>


DDx - shoulder lesions:
Lipoblastoma like tumor in 26 yo woman, tumor of pelvis. A. Lobulated appearance at low power. B. Cytologically bland lipoblasts with a myxoid stroma. C. Numerous thin-walled branching blood vessels. D. Loose collagenous stroma. The morphologic features, combined with molecular findings of negative DDI T3 gene rearrangement and lack of MDM2 amplification permit the diagnosis.
*[[Elastofibroma]].
*[[Desmoplastic fibroblastoma]].


===Microscopic===
==Lipoma==
Features:
{{Main|Lipoma}}
*Multinucleated cells - "floret cells" - '''key feature'''.
**Solid eosinophilic cytoplasm.
**Peripheral nuclei - impart a knobby border to the cells.
*Fibrous septa.


Notes:
==Pleomorphic lipoma==
*May overlap with ''[[spindle cell lipoma]]''.<ref name=spc_stanford>URL: [http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/ http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/]. Accessed on: 4 December 2010.</ref>
{{Main|Pleomorphic lipoma}}
*Floret cell - may look similar to [[Touton giant cell]]s.
 
Images:
*[http://www.webpathology.com/image.asp?case=435&n=1 Pleomorphic lipoma - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=435 Pleomorphic lipoma - high mag. (webpathology.com)].
 
DDx:
*[[Liposarcoma]].<ref name=pmid6884998>{{Cite journal  | last1 = Azzopardi | first1 = JG. | last2 = Iocco | first2 = J. | last3 = Salm | first3 = R. | title = Pleomorphic lipoma: a tumour simulating liposarcoma. | journal = Histopathology | volume = 7 | issue = 4 | pages = 511-23 | month = Jul | year = 1983 | doi =  | PMID = 6884998 }}</ref>
*Ancient [[neurofibroma]].
*Ancient [[schwannoma]].
 
===IHC===
*AR +ve - ~95% in men, ~85% in women.<ref name=pmid18181679>{{Cite journal  | last1 = Syed | first1 = S. | last2 = Martin | first2 = AM. | last3 = Haupt | first3 = H. | last4 = Podolski | first4 = V. | last5 = Brooks | first5 = JJ. | title = Frequent detection of androgen receptors in spindle cell lipomas: an explanation for this lesion's male predominance? | journal = Arch Pathol Lab Med | volume = 132 | issue = 1 | pages = 81-3 | month = Jan | year = 2008 | doi = 10.1043/1543-2165(2008)132[81:FDOARI]2.0.CO;2 | PMID = 18181679 }}</ref>


==Spindle cell lipoma==
==Spindle cell lipoma==
===General===
{{Main|Spindle cell lipoma}}
*Rare.
*Predominantly men.<ref name=pmid15371618/>
 
Note:
*Spindle cell lipoma may immunohistochemically and histomorphologically overlap with ''mammary-type myofibroblastoma''<ref name=pmid11474286>{{Cite journal  | last1 = McMenamin | first1 = ME. | last2 = Fletcher | first2 = CD. | title = Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma. | journal = Am J Surg Pathol | volume = 25 | issue = 8 | pages = 1022-9 | month = Aug | year = 2001 | doi =  | PMID = 11474286 }}</ref> - see: ''[[mammary myofibroblastoma]]''.
 
===Microscopic===
Features:<ref name=pmid15371618>{{Cite journal  | last1 = Murphey | first1 = MD. | last2 = Carroll | first2 = JF. | last3 = Flemming | first3 = DJ. | last4 = Pope | first4 = TL. | last5 = Gannon | first5 = FH. | last6 = Kransdorf | first6 = MJ. | title = From the archives of the AFIP: benign musculoskeletal lipomatous lesions. | journal = Radiographics | volume = 24 | issue = 5 | pages = 1433-66 | month =  | year =  | doi = 10.1148/rg.245045120 | PMID = 15371618 }}</ref>
*Aligned bland spindled cells adjacent to fat.
*Rope-like collagen bundles - '''key feature'''.
**May be described as "shreaded wheat".
*+/-[[Myxoid]] component.
*+/-[[staghorn vessels|Staghorn-like vessels]].
 
Notes:
*May overlap with ''[[pleomorphic lipoma]]''.<ref name=spc_stanford>URL: [http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/ http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/]. Accessed on: 4 December 2010.</ref>
 
DDx:
*[[Neurofibroma]].
*Spindle cell liposarcoma - extremely rare.<ref name=pmid8067512>{{Cite journal  | last1 = Dei Tos | first1 = AP. | last2 = Mentzel | first2 = T. | last3 = Newman | first3 = PL. | last4 = Fletcher | first4 = CD. | title = Spindle cell liposarcoma, a hitherto unrecognized variant of liposarcoma. Analysis of six cases. | journal = Am J Surg Pathol | volume = 18 | issue = 9 | pages = 913-21 | month = Sep | year = 1994 | doi =  | PMID = 8067512 }}</ref>
 
====Image====
www:
*[http://www.sarcoma.org/pathology_review/round%20cell%20and%20soft%20tissue%20tumors/source/spindle_cell_lipoma3.html Spindle cell lipoma (sarcoma.org)].
 
===IHC===
*CD34 +ve.<ref name=pmid20559119>{{Cite journal  | last1 = Wood | first1 = L. | last2 = Fountaine | first2 = TJ. | last3 = Rosamilia | first3 = L. | last4 = Helm | first4 = KF. | last5 = Clarke | first5 = LE. | title = Cutaneous CD34+ spindle cell neoplasms: Histopathologic features distinguish spindle cell lipoma, solitary fibrous tumor, and dermatofibrosarcoma protuberans. | journal = Am J Dermatopathol | volume = 32 | issue = 8 | pages = 764-8 | month = Dec | year = 2010 | doi = 10.1097/DAD.0b013e3181d0c587 | PMID = 20559119 }}</ref>
*Desmin +ve.
*S100 -ve. (???)


==Hibernoma==
==Hibernoma==
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==Atypical lipomatous tumour==
==Atypical lipomatous tumour==
*[[AKA]] ''well-differentiated liposarcoma'', abbreviated ''WDLPS''.
*[[AKA]] ''well-differentiated liposarcoma'', abbreviated ''WDLPS''.<ref name=pmid24659226>{{Cite journal  | last1 = Creytens | first1 = D. | last2 = van Gorp | first2 = J. | last3 = Savola | first3 = S. | last4 = Ferdinande | first4 = L. | last5 = Mentzel | first5 = T. | last6 = Libbrecht | first6 = L. | title = Atypical spindle cell lipoma: a clinicopathologic, immunohistochemical, and molecular study emphasizing its relationship to classical spindle cell lipoma. | journal = Virchows Arch | volume = 465 | issue = 1 | pages = 97-108 | month = Jul | year = 2014 | doi = 10.1007/s00428-014-1568-8 | PMID = 24659226 }}</ref>
*Abbreviated ''ALT/WDLPS''.
*Abbreviated ''ALT/WDLPS''.


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==Liposarcoma==
==Liposarcoma==
{{Main|Liposarcoma}}
{{Main|Liposarcoma}}
==Angiolipoma==
===General===
*May be syndromic - typically [[autosomal recessive]].<ref name=pmid25671454>{{cite journal |authors=Garib G, Siegal GP, Andea AA |title=Autosomal-dominant familial angiolipomatosis |journal=Cutis |volume=95 |issue=1 |pages=E26–9 |date=January 2015 |pmid=25671454 |doi= |url=}}</ref>
*Can be seen in the context of [[Birt–Hogg–Dubé syndrome]].<ref name=pmid8734663>{{cite journal |authors=Chung JY, Ramos-Caro FA, Beers B, Ford MJ, Flowers F |title=Multiple lipomas, angiolipomas, and parathyroid adenomas in a patient with Birt-Hogg-Dube syndrome |journal=Int J Dermatol |volume=35 |issue=5 |pages=365–7 |date=May 1996 |pmid=8734663 |doi=10.1111/j.1365-4362.1996.tb03642.x |url=}}</ref>
*[[Painful skin lesion]].
===Microscopic===
Features:
*Adipose tissue.
*Small blood vessels (clustered).
DDx:
*[[Liposarcoma]].


=See also=
=See also=
*[[Soft tissue lesions]].
*[[Soft tissue lesions]].
*[[Bone]].
*[[Bone]].
*[[Brown fat]].


=References=
=References=
Michael
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