Difference between revisions of "Pleomorphic lipoma"

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#redirect [[Adipocytic_tumours#Pleomorphic_lipoma]]
'''Pleomorphic_lipoma''' is a rare [[Adipocytic tumours|adipocytic tumour]].
 
==General==
*Rare.
*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>
*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:
*[[Elastofibroma]].
*[[Desmoplastic fibroblastoma]].
 
==Microscopic==
Features:
*Multinucleated cells - "floret cells" - '''key feature'''.
**Solid eosinophilic cytoplasm.
**Peripheral nuclei - impart a knobby border to the cells.
*Fibrous septa.
 
Notes:
*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>
*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>
*CD34 +ve (26 +ve of 26 cases<ref name=pmid25219904>{{Cite journal  | last1 = Cheah | first1 = A. | last2 = Billings | first2 = S. | last3 = Goldblum | first3 = J. | last4 = Hornick | first4 = J. | last5 = Uddin | first5 = N. | last6 = Rubin | first6 = B. | title = Spindle cell/pleomorphic lipomas of the face: an under-recognized diagnosis. | journal = Histopathology | volume = 66 | issue = 3 | pages = 430-7 | month = Feb | year = 2015 | doi = 10.1111/his.12548 | PMID = 25219904 }}</ref>).
*Desmin -ve (0 +ve of 20 cases<ref name=pmid25219904/>).
*ER -ve/+ve (5 +ve of 21 cases<ref name=pmid25219904/>).
 
==See also==
*[[Adipocytic tumours]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Adipocytic tumours]]

Revision as of 22:58, 1 May 2016

Pleomorphic_lipoma is a rare adipocytic tumour.

General

  • Rare.
  • May mimic a malignancy.[1]
  • Male > female.[2]

Gross

  • Classically shoulder and neck region in adults.[3]

DDx - shoulder lesions:

Microscopic

Features:

  • Multinucleated cells - "floret cells" - key feature.
    • Solid eosinophilic cytoplasm.
    • Peripheral nuclei - impart a knobby border to the cells.
  • Fibrous septa.

Notes:

Images:

DDx:

IHC

  • AR +ve - ~95% in men, ~85% in women.[2]
  • CD34 +ve (26 +ve of 26 cases[6]).
  • Desmin -ve (0 +ve of 20 cases[6]).
  • ER -ve/+ve (5 +ve of 21 cases[6]).

See also

References

  1. ↑ Persichetti, P.; Di Lella, F.; Marangi, GF.; Cagli, B.; Simone, P.; Tenna, S.; Rabitri, C.; Cassandro, R. et al. "Pleomorphic lipoma: a definite histopathological entity.". Anticancer Res 24 (5B): 3157-9. PMID 15510605.
  2. ↑ 2.0 2.1 Syed, S.; Martin, AM.; Haupt, H.; Podolski, V.; Brooks, JJ. (Jan 2008). "Frequent detection of androgen receptors in spindle cell lipomas: an explanation for this lesion's male predominance?". Arch Pathol Lab Med 132 (1): 81-3. doi:10.1043/1543-2165(2008)132[81:FDOARI]2.0.CO;2. PMID 18181679.
  3. ↑ URL: http://www.webpathology.com/image.asp?n=2&Case=435. Accessed on: 3 October 2011.
  4. ↑ URL: http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/. Accessed on: 4 December 2010.
  5. ↑ Azzopardi, JG.; Iocco, J.; Salm, R. (Jul 1983). "Pleomorphic lipoma: a tumour simulating liposarcoma.". Histopathology 7 (4): 511-23. PMID 6884998.
  6. ↑ 6.0 6.1 6.2 Cheah, A.; Billings, S.; Goldblum, J.; Hornick, J.; Uddin, N.; Rubin, B. (Feb 2015). "Spindle cell/pleomorphic lipomas of the face: an under-recognized diagnosis.". Histopathology 66 (3): 430-7. doi:10.1111/his.12548. PMID 25219904.
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