Difference between revisions of "Spindle cell lipoma"

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#redirect [[Adipocytic_tumours#Spindle_cell_lipoma]]
 
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Spindle_cell_lipoma_--_high_mag.jpg
| Width      =
| Caption    = [[Micrograph]] showing a spindle cell lipoma. [[H&E stain]].
| Synonyms  =
| Micro      = aligned bland spindled cells adjacent to fat, rope-like collagen bundles (key feature), +/-[[myxoid]] component, +/-[[staghorn vessels|staghorn-like vessels]]
| Subtypes  =
| LMDDx      = [[neurofibroma]], spindle cell [[liposarcoma]], [[pleomorphic lipoma]]
| Stains    =
| IHC        = CD34 +ve, MDM2 -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      =
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Spindle cell lipoma''' is a rare benign [[adipocytic tumours|adipocytic tumour]].
 
==General==
*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>
 
===Images===
<gallery>
Image: Spindle cell lipoma -- low mag.jpg | SCL - low mag. (WC/Nephron)
Image: Spindle cell lipoma -- intermed mag.jpg | SCL - intermed. mag. (WC/Nephron)
Image: Spindle cell lipoma -- high mag.jpg | SCL - high mag. (WC/Nephron)
</gallery>
<gallery>
Image: Spindle Cell Lipoma (2275051876).jpg | SCL (WC/Uthman)
</gallery>
====www====
*[http://www.webpathology.com/image.asp?n=3&Case=434 Spindle cell lipoma (webpathology.com)].
 
==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. (???)
 
Lipoma versus liposarcoma:
*MDM2 -ve.<ref name=pmid23529275>{{Cite journal  | last1 = Alshenawy | first1 = H. | title = Can HMGI-C be used as an aid with MDM2 and CDK4 to differentiate liposarcoma subtypes from their mimics? | journal = J Cancer Res Clin Oncol | volume = 139 | issue = 6 | pages = 1073-81 | month = Jun | year = 2013 | doi = 10.1007/s00432-013-1420-6 | PMID = 23529275 }}</ref>
*p16 -ve.<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>
 
==Molecular==
*Retinoblastoma (Rb) deletions.<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>
*CDK4 no amplication ([[FISH]]).<ref name=pmid24659226/>
 
==See also==
*[[Mammary myofibroblastoma]].
*[[Pleomorphic lipoma]].
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Adipocytic tumours]]

Latest revision as of 06:20, 30 December 2017

Spindle cell lipoma
Diagnosis in short

Micrograph showing a spindle cell lipoma. H&E stain.
LM aligned bland spindled cells adjacent to fat, rope-like collagen bundles (key feature), +/-myxoid component, +/-staghorn-like vessels
LM DDx neurofibroma, spindle cell liposarcoma, pleomorphic lipoma
IHC CD34 +ve, MDM2 -ve
Prevalence uncommon
Prognosis benign

Spindle cell lipoma is a rare benign adipocytic tumour.

General

  • Rare.
  • Predominantly men.[1]

Note:

  • Spindle cell lipoma may immunohistochemically and histomorphologically overlap with mammary-type myofibroblastoma[2] - see: mammary myofibroblastoma.

Microscopic

Features:[1]

  • Aligned bland spindled cells adjacent to fat.
  • Rope-like collagen bundles - key feature.
    • May be described as "shreaded wheat".
  • +/-Myxoid component.
  • +/-Staghorn-like vessels.

Notes:

DDx:

Images

  • SCL - low mag. (WC/Nephron)

  • SCL - intermed. mag. (WC/Nephron)

  • SCL - high mag. (WC/Nephron)

  • SCL (WC/Uthman)

www

IHC

  • CD34 +ve.[5]
  • Desmin +ve.
  • S100 -ve. (???)

Lipoma versus liposarcoma:

Molecular

  • Retinoblastoma (Rb) deletions.[7]
  • CDK4 no amplication (FISH).[7]

See also

References

  1. ↑ 1.0 1.1 Murphey, MD.; Carroll, JF.; Flemming, DJ.; Pope, TL.; Gannon, FH.; Kransdorf, MJ.. "From the archives of the AFIP: benign musculoskeletal lipomatous lesions.". Radiographics 24 (5): 1433-66. doi:10.1148/rg.245045120. PMID 15371618.
  2. ↑ McMenamin, ME.; Fletcher, CD. (Aug 2001). "Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma.". Am J Surg Pathol 25 (8): 1022-9. PMID 11474286.
  3. ↑ URL: http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/. Accessed on: 4 December 2010.
  4. ↑ Dei Tos, AP.; Mentzel, T.; Newman, PL.; Fletcher, CD. (Sep 1994). "Spindle cell liposarcoma, a hitherto unrecognized variant of liposarcoma. Analysis of six cases.". Am J Surg Pathol 18 (9): 913-21. PMID 8067512.
  5. ↑ Wood, L.; Fountaine, TJ.; Rosamilia, L.; Helm, KF.; Clarke, LE. (Dec 2010). "Cutaneous CD34+ spindle cell neoplasms: Histopathologic features distinguish spindle cell lipoma, solitary fibrous tumor, and dermatofibrosarcoma protuberans.". Am J Dermatopathol 32 (8): 764-8. doi:10.1097/DAD.0b013e3181d0c587. PMID 20559119.
  6. ↑ Alshenawy, H. (Jun 2013). "Can HMGI-C be used as an aid with MDM2 and CDK4 to differentiate liposarcoma subtypes from their mimics?". J Cancer Res Clin Oncol 139 (6): 1073-81. doi:10.1007/s00432-013-1420-6. PMID 23529275.
  7. ↑ 7.0 7.1 7.2 Creytens, D.; van Gorp, J.; Savola, S.; Ferdinande, L.; Mentzel, T.; Libbrecht, L. (Jul 2014). "Atypical spindle cell lipoma: a clinicopathologic, immunohistochemical, and molecular study emphasizing its relationship to classical spindle cell lipoma.". Virchows Arch 465 (1): 97-108. doi:10.1007/s00428-014-1568-8. PMID 24659226.
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