Adipocytic tumours

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Adipocytic tumours fall into the grouping soft tissue lesions and includes things that are very common (e.g. lipoma) and everything from benign to malignant.

Lipoma

General

  • Benign.

Microscopic

Features:

  • Collection of mature adipocytes.

Notes:

  • Microscopically not distinguishable from mature clump of fat.
    • The lesion must be labeled lipoma to be signed-out as such.

Hibernoma

General

  • Consists of brown fat (present in the infants to generate heat).[1]
  • Benign.
  • Usually asymptomatic.[2]

Epidemiology

  • Young adults.

Gross

  • Well-circumscribed.
  • Lobulated and light-brown on sectioning.

Microscopic

Features:[3]

  • Large polygonal/oval cells:
    • Nucleus - central & small.[4]
      • Nucleoli typically prominent.[5]
    • Cytoplasm - multivacuolated, oval, eosinophilic, granular.

Image:

Liposarcoma

  • Most common malignant sarcoma in the retroperitoneum.

Microscopy

Features:

  • Lipoblasts:
    • Large sharply demarcated vacuole.
    • Nucleus:
      • Hyperchromatic (dark staining) nucleus.
      • Eccentric location.
      • Nuclear indentation.

Images:

IHC

  • IHC is of limited value.
  • S-100 +ve ~1/3 of the time.
  • Reticulin ???.

See also

References

  1. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 605. ISBN 978-0781765275.
  2. Ahmed SA, Schuller I (December 2008). "Pediatric hibernoma: a case review". J. Pediatr. Hematol. Oncol. 30 (12): 900–1. doi:10.1097/MPH.0b013e318184e6dd. PMID 19131775.
  3. Chen DY, Wang CM, Chan HL (March 1998). "Hibernoma. Case report and literature review". Dermatol Surg 24 (3): 393–5. PMID 9537018.
  4. http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70271-6
  5. http://surgpathcriteria.stanford.edu/softfat/hibernoma/