Pleomorphic lipoma

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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:

DDx:

Images

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/ 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.