Spindle cell lipoma

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Spindle cell lipoma
Diagnosis in short

Micrograph showing a spindle cell lipoma. H&E stain.

LM aligned bland spindled cells adjacent to fat, rope-like collagen bundles (key feature), +/-myxoid component, +/-staghorn-like vessels
LM DDx neurofibroma, spindle cell liposarcoma, pleomorphic lipoma
IHC CD34 +ve, MDM2 -ve
Prevalence uncommon
Prognosis benign

Spindle cell lipoma is a rare benign adipocytic tumour.

General

  • Rare.
  • Predominantly men.[1]

Note:

  • Spindle cell lipoma may immunohistochemically and histomorphologically overlap with mammary-type myofibroblastoma[2] - see: mammary myofibroblastoma.

Microscopic

Features:[1]

  • Aligned bland spindled cells adjacent to fat.
  • Rope-like collagen bundles - key feature.
    • May be described as "shreaded wheat".
  • +/-Myxoid component.
  • +/-Staghorn-like vessels.

Notes:

DDx:

Images

www

IHC

  • CD34 +ve.[5]
  • Desmin +ve.
  • S100 -ve. (???)

Lipoma versus liposarcoma:

Molecular

  • Retinoblastoma (Rb) deletions.[7]
  • CDK4 no amplication (FISH).[7]

See also

References

  1. 1.0 1.1 Murphey, MD.; Carroll, JF.; Flemming, DJ.; Pope, TL.; Gannon, FH.; Kransdorf, MJ.. "From the archives of the AFIP: benign musculoskeletal lipomatous lesions.". Radiographics 24 (5): 1433-66. doi:10.1148/rg.245045120. PMID 15371618.
  2. McMenamin, ME.; Fletcher, CD. (Aug 2001). "Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma.". Am J Surg Pathol 25 (8): 1022-9. PMID 11474286.
  3. URL: http://surgpathcriteria.stanford.edu/softfat/spindle_cell_lipoma/. Accessed on: 4 December 2010.
  4. Dei Tos, AP.; Mentzel, T.; Newman, PL.; Fletcher, CD. (Sep 1994). "Spindle cell liposarcoma, a hitherto unrecognized variant of liposarcoma. Analysis of six cases.". Am J Surg Pathol 18 (9): 913-21. PMID 8067512.
  5. Wood, L.; Fountaine, TJ.; Rosamilia, L.; Helm, KF.; Clarke, LE. (Dec 2010). "Cutaneous CD34+ spindle cell neoplasms: Histopathologic features distinguish spindle cell lipoma, solitary fibrous tumor, and dermatofibrosarcoma protuberans.". Am J Dermatopathol 32 (8): 764-8. doi:10.1097/DAD.0b013e3181d0c587. PMID 20559119.
  6. Alshenawy, H. (Jun 2013). "Can HMGI-C be used as an aid with MDM2 and CDK4 to differentiate liposarcoma subtypes from their mimics?". J Cancer Res Clin Oncol 139 (6): 1073-81. doi:10.1007/s00432-013-1420-6. PMID 23529275.
  7. 7.0 7.1 7.2 Creytens, D.; van Gorp, J.; Savola, S.; Ferdinande, L.; Mentzel, T.; Libbrecht, L. (Jul 2014). "Atypical spindle cell lipoma: a clinicopathologic, immunohistochemical, and molecular study emphasizing its relationship to classical spindle cell lipoma.". Virchows Arch 465 (1): 97-108. doi:10.1007/s00428-014-1568-8. PMID 24659226.