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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. | '''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== | =Overview= | ||
This grouping includes a number of tumours, which can be divided based on their behaviour into ''benign'', ''intermediate'' and ''malignant''. | |||
==Benign== | |||
Benign adipocytic tumours:<ref name=Ref_WMSP_601>{{Ref WMSP|601}}</ref> | |||
*[[Lipoma]]. | |||
*[[Angiolipoma]]. | |||
*[[Myolipoma]]. | |||
*[[Pleomorphic lipoma]]/[[spindle cell lipoma]]. | |||
*Lipomatosis. | |||
*Lipomatosis of nerve. | |||
*[[Lipoblastoma]]. | |||
*Extrarenal [[angiomyolipoma]]. | |||
*Extra-adrenal [[myelolipoma]]. | |||
*[[Hibernoma]]. | |||
==Intermediate== | |||
Intermediate adipocytic tumours:<ref name=Ref_WMSP_601>{{Ref WMSP|601}}</ref> | |||
*Atypical lipomatous tumour. | |||
==Malignant== | |||
Malignant adipocytic tumours:<ref name=Ref_WMSP_601>{{Ref WMSP|601}}</ref> | |||
*Dedifferentiated liposarcoma. | |||
*Myxoid liposarcoma. | |||
*Pleomorphic liposarcoma. | |||
*Mixed-type liposarcoma. | |||
*Liposarcoma NOS. | |||
=Detail section= | |||
==Normal mature fat== | |||
===Microscopic=== | |||
Features: | |||
*Adipocytes of approximately equal size. | |||
*Not vascular. | |||
*No nuclear hyperchromasia. | |||
Notes: | |||
*May have nuclear pseudoinclusions (Lockhern cell).<ref>URL: [http://journals.lww.com/amjdermatopathology/Citation/2004/12000/Original_Observation_to_Rediscovery__Nuclear.9.aspx http://journals.lww.com/amjdermatopathology/Citation/2004/12000/Original_Observation_to_Rediscovery__Nuclear.9.aspx]. Accessed on: 18 April 2011.</ref> | |||
**There is some suggestion this is not benign.<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970574-5 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970574-5]. Accessed on: 18 April 2011.</ref> | |||
===IHC=== | |||
*[[S-100]] +ve. | |||
==Lipoblastoma== | |||
===General=== | ===General=== | ||
* | *Rare paediatric tumour.<ref name=pmid20472310>{{Cite journal | last1 = Pham | first1 = NS. | last2 = Poirier | first2 = B. | last3 = Fuller | first3 = SC. | last4 = Dublin | first4 = AB. | last5 = Tollefson | first5 = TT. | title = Pediatric lipoblastoma in the head and neck: a systematic review of 48 reported cases. | journal = Int J Pediatr Otorhinolaryngol | volume = 74 | issue = 7 | pages = 723-8 | month = Jul | year = 2010 | doi = 10.1016/j.ijporl.2010.04.010 | PMID = 20472310 }}</ref> | ||
Usual presentation:<ref name=pmid20472310/> | |||
*Painless neck mass. | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
* | *Nests of cells in the dermis with abundant pale cytoplasm - vaguely resemble adipocytes. | ||
**Smaller than mature adipocytes. | |||
DDx: | |||
*[[Myxoid liposarcoma]].<ref name=pmid21212605>{{Cite journal | last1 = Nagano | first1 = A. | last2 = Ohno | first2 = T. | last3 = Nishimoto | first3 = Y. | last4 = Hirose | first4 = Y. | last5 = Miyake | first5 = S. | last6 = Shimizu | first6 = K. | title = Lipoblastoma mimicking myxoid liposarcoma: a clinical report and literature review. | journal = Tohoku J Exp Med | volume = 223 | issue = 1 | pages = 75-8 | month = | year = 2011 | doi = | PMID = 21212605 }}</ref> | |||
Images: | |||
*[http://www.sarcomaimages.com/index.php?v=Lipoblastoma Lipoblastoma (sarcomaimages.com)]. | |||
==Lipoblastoma like tumor== | |||
[[File: 5 22974716644038 sl 1.png|Lipoblastoma like tumor]] | |||
[[File: 5 22974716644038 sl 2.png|Lipoblastoma like tumor]] | |||
[[File: 5 22974716644038 sl 3.png|Lipoblastoma like tumor]] | |||
[[File: 5 22974716644038 sl 4.png|Lipoblastoma like tumor]] | |||
Lipoblastoma like tumor in 26 yo woman, tumor of pelvis. A. Lobulated appearance at low power. B. Cytologically bland lipoblasts with a myxoid stroma. C. Numerous thin-walled branching blood vessels. D. Loose collagenous stroma. The morphologic features, combined with molecular findings of negative DDI T3 gene rearrangement and lack of MDM2 amplification permit the diagnosis. | |||
==Lipoma== | |||
{{Main|Lipoma}} | |||
==Pleomorphic lipoma== | |||
{{Main|Pleomorphic lipoma}} | |||
==Spindle cell lipoma== | |||
{{Main|Spindle cell lipoma}} | |||
==Hibernoma== | ==Hibernoma== | ||
{{Main|Hibernoma}} | |||
=== | ==Atypical lipomatous tumour== | ||
* | *[[AKA]] ''well-differentiated liposarcoma'', abbreviated ''WDLPS''.<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> | ||
*Abbreviated ''ALT/WDLPS''. | |||
=== | ===General=== | ||
* | *''Atypical lipomatous tumour'' is a term used to save people with a (curable) peripheral liposarcoma from getting denied life insurance. | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref>{{ | Features:<ref>{{Ref WMSP|605}}</ref> | ||
*Large | *Large adipocytes. | ||
* | *Atypical lipoblasts - focal, scattered: | ||
** | **Nuclear hyperchromasia. | ||
** | **+/-Multinucleated. | ||
==Liposarcoma== | ==Liposarcoma== | ||
{{Main|Liposarcoma}} | |||
=== | ==Angiolipoma== | ||
===General=== | |||
*[ | *May be syndromic - typically [[autosomal recessive]].<ref name=pmid25671454>{{cite journal |authors=Garib G, Siegal GP, Andea AA |title=Autosomal-dominant familial angiolipomatosis |journal=Cutis |volume=95 |issue=1 |pages=E26–9 |date=January 2015 |pmid=25671454 |doi= |url=}}</ref> | ||
*[ | *Can be seen in the context of [[Birt–Hogg–Dubé syndrome]].<ref name=pmid8734663>{{cite journal |authors=Chung JY, Ramos-Caro FA, Beers B, Ford MJ, Flowers F |title=Multiple lipomas, angiolipomas, and parathyroid adenomas in a patient with Birt-Hogg-Dube syndrome |journal=Int J Dermatol |volume=35 |issue=5 |pages=365–7 |date=May 1996 |pmid=8734663 |doi=10.1111/j.1365-4362.1996.tb03642.x |url=}}</ref> | ||
*[[Painful skin lesion]]. | |||
=== | ===Microscopic=== | ||
* | Features: | ||
*Adipose tissue. | |||
*Small blood vessels (clustered). | |||
DDx: | |||
* | *[[Liposarcoma]]. | ||
=See also= | |||
*[[Soft tissue lesions]]. | *[[Soft tissue lesions]]. | ||
*[[Bone]]. | *[[Bone]]. | ||
*[[Brown fat]]. | |||
=References= | |||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Adipocytic tumours]] | |||
[[Category:Soft tissue lesions]] | [[Category:Soft tissue lesions]] |
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