48,460
edits
Difference between revisions of "Lipoma"
Jump to navigation
Jump to search
tweak
(→Images: more images) |
(tweak) |
||
| (10 intermediate revisions by the same user not shown) | |||
| Line 4: | Line 4: | ||
| Width = | | Width = | ||
| Caption = Mature adipose tissue (lipoma). [[H&E stain]]. | | Caption = Mature adipose tissue (lipoma). [[H&E stain]]. | ||
| Synonyms = [[steatoma]] (old term, ambiguous) | |||
| Micro = mature adipocytes | | Micro = mature adipocytes | ||
| Subtypes = | | Subtypes = | ||
| Line 10: | Line 11: | ||
| IHC = S-100 +ve | | IHC = S-100 +ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = MDM2/CDK4 amplification absent | ||
| IF = | | IF = | ||
| Gross = | | Gross = soft yellow tissue - typically with a thin capsule and lobulated | ||
| Grossing = | | Grossing = | ||
| Site = [[soft tissue]] | | Site = [[soft tissue]] | ||
| Line 18: | Line 19: | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = [[pillow sign]] (endoscopy) | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = common | | Prevalence = common | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = smooth yellow coloured submucosal lesion | ||
| Prognosis = benign | | Prognosis = benign | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = surgical removal or follow-up | |||
}} | }} | ||
'''Lipoma''' is a benign [[adipocytic tumours|adipocytic tumour]]. | '''Lipoma''' is a benign [[adipocytic tumours|adipocytic tumour]]. | ||
| Line 34: | Line 36: | ||
*Several variants exist. | *Several variants exist. | ||
**Angiolipoma - one of the (classically) [[painful skin lesions]]. | **Angiolipoma - one of the (classically) [[painful skin lesions]]. | ||
*May be seen in association with MERRF syndrome (myoclonic epilepsy with ragged-red fibres).<ref name=pmid21865105>{{Cite journal | last1 = Jones | first1 = AP. | last2 = Lewis | first2 = CJ. | last3 = Dildey | first3 = P. | last4 = Hide | first4 = G. | last5 = Ragbir | first5 = M. | title = Lipoma or liposarcoma? A cautionary case report. | journal = J Plast Reconstr Aesthet Surg | volume = 65 | issue = 1 | pages = e11-4 | month = Jan | year = 2012 | doi = 10.1016/j.bjps.2011.08.004 | PMID = 21865105 }}</ref> | |||
*May be seen in the context of ''[[Madelung's disease]]''.<ref name=pmid29129710>{{Cite journal | last1 = Mayo Yáñez | first1 = M. | last2 = González Poggioli | first2 = N. | last3 = Álvarez-Buylla Blanco | first3 = M. | last4 = Herranz González-Botas | first4 = J. | title = Benign symmetric lipomatosis with lingual involvement: Case report and literature review. | journal = J Stomatol Oral Maxillofac Surg | volume = | issue = | pages = | month = Nov | year = 2017 | doi = 10.1016/j.jormas.2017.11.006 | PMID = 29129710 }}</ref> | |||
==Gross== | |||
*Soft yellow tissue - typically lobulated and with a very thin capsule. | |||
Note: | |||
*May be quite large ~10 cm. | |||
*Thigh lesions are more likely to the malignant than other sites.<ref name=pmid27020493/> | |||
==Microscopic== | ==Microscopic== | ||
| Line 88: | Line 99: | ||
Image:Yellow_adipose_tissue_in_paraffin_section_-_lipids_washed_out.jpg | Mature fat. (WC) | Image:Yellow_adipose_tissue_in_paraffin_section_-_lipids_washed_out.jpg | Mature fat. (WC) | ||
</gallery> | </gallery> | ||
==Molecular== | |||
*MDM2/CDK4 gene amplification absent. | |||
**Testing suggested in lesions greater than 10 cm, thigh lesions and lesions with cytologic atypia.<ref name=pmid27020493>{{Cite journal | last1 = Wong | first1 = DD. | last2 = Low | first2 = IC. | last3 = Peverall | first3 = J. | last4 = Robbins | first4 = PD. | last5 = Spagnolo | first5 = DV. | last6 = Nairn | first6 = R. | last7 = Carey-Smith | first7 = RL. | last8 = Wood | first8 = D. | title = MDM2/CDK4 gene amplification in large/deep-seated 'lipomas': incidence, predictors and clinical significance. | journal = Pathology | volume = 48 | issue = 3 | pages = 203-9 | month = Apr | year = 2016 | doi = 10.1016/j.pathol.2016.02.007 | PMID = 27020493 }}</ref> | |||
==Sign out== | ==Sign out== | ||
===Large lesion looks like lipoma=== | |||
Bland lesions may be well-differentiated liposarcoma.<ref>URL: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422587/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422587/]. Accessed on: 3 June 2017.</ref> Lesions >10 cm should be of concern. | |||
<pre> | |||
Lesion (Submitted as "Lipoma"), Right Neck, Excision: | |||
- Bland appearing adipose tissue suggestive of lipoma, see comment. | |||
- One benign lymph node. | |||
Comment: | |||
Due to the size of the lesion, the case will be sent to a soft tissue pathologist for review. | |||
</pre> | |||
===Block letter=== | |||
<pre> | <pre> | ||
SUBCUTANEOUS TISSUE ("LIPOMA"), LEFT AXILLA, EXCISION: | SUBCUTANEOUS TISSUE ("LIPOMA"), LEFT AXILLA, EXCISION: | ||