Lipomatous tumor: Difference between revisions
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File:Histopathology of a fibrolipoma.jpg|'''Fibrolipoma''' is a lipoma with focal areas of large amounts of fibrous tissue.<br>A '''sclerotic lipoma''' is one step further: a predominantly fibrous lesion with focal areas of fat.<ref>{{cite web|url=http://surgpathcriteria.stanford.edu/softfat/lipoma/fibrolipoma.html|title=Lipoma Variant: Fibrolipoma|website=Stanford University School of Medicine|accessdate=2020-02-10}}</ref><br>If unsure of degree of fibrosis: Simply report as lipoma. | File:Histopathology of a fibrolipoma.jpg|'''Fibrolipoma''' is a lipoma with focal areas of large amounts of fibrous tissue.<br>A '''sclerotic lipoma''' is one step further: a predominantly fibrous lesion with focal areas of fat.<ref>{{cite web|url=http://surgpathcriteria.stanford.edu/softfat/lipoma/fibrolipoma.html|title=Lipoma Variant: Fibrolipoma|website=Stanford University School of Medicine|accessdate=2020-02-10}}</ref><br>If unsure of degree of fibrosis: Simply report as lipoma. | ||
File:Histopathology of angiolipoma.jpg|'''Angiolipoma''' is a lipoma with abundant capillaries, with hyaline or fibrin (pictured) thrombi.<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/softtissueadiposeangiolipoma.html|title=Soft tissue - Adipose tissue tumors - Lipoma and variants - Angiolipoma|author=Vijay Shankar|website=Pathology Outlines}} Topic Completed: 1 August 2012. Minor changes: 20 March 2019</ref> | File:Histopathology of angiolipoma.jpg|'''Angiolipoma''' is a lipoma with abundant capillaries, with hyaline or fibrin (pictured) thrombi.<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/softtissueadiposeangiolipoma.html|title=Soft tissue - Adipose tissue tumors - Lipoma and variants - Angiolipoma|author=Vijay Shankar|website=Pathology Outlines}} Topic Completed: 1 August 2012. Minor changes: 20 March 2019</ref> | ||
File:Histopathology of liposarcoma, annotated.jpg|Main features of '''liposarcoma''':<ref name=PathologyOutlines>{{cite web|url=https://www.pathologyoutlines.com/topic/softtissuewdliposarcoma.html%7Ctitle=Liposarcoma|author=Michael R. Clay, M.D.|website=PathologyOutlines|title=Liposarcoma}} Topic Completed: 1 November 2017. Minor changes: 11 May 2021</ref><br>- Spindle cells with enlarged, hyperchromatic nuclei.<br>- Apparently univacuolated adipocytes (may look normal).<br>- [[Lipoblast]]s | File:Histopathology of liposarcoma, annotated.jpg|Main features of '''liposarcoma''':<ref name=PathologyOutlines-Liposarcoma>{{cite web|url=https://www.pathologyoutlines.com/topic/softtissuewdliposarcoma.html%7Ctitle=Liposarcoma|author=Michael R. Clay, M.D.|website=PathologyOutlines|title=Liposarcoma}} Topic Completed: 1 November 2017. Minor changes: 11 May 2021</ref><br>- Spindle cells with enlarged, hyperchromatic nuclei.<br>- Apparently univacuolated adipocytes (may look normal).<br>- [[Lipoblast]]s, but is neither necessary nor sufficient for diagnosis. | ||
File:Lipoblast features, annotated.png|Lipoblast features | |||
File:Myxoid liposarcoma (16105753363).jpg|'''Myxoid liposarcoma''': Hypercellular solid sheets of cells lying back to back, with round cells or primitive cytomorphology.<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/softtissuemyxoidliposarcoma.html|title=Soft tissue - Adipose tissue - Myxoid liposarcoma|author=Michael R. Clay|website=PathologyOutlines}} Topic Completed: 1 January 2018. Revised: 20 March 2019</ref> | File:Myxoid liposarcoma (16105753363).jpg|'''Myxoid liposarcoma''': Hypercellular solid sheets of cells lying back to back, with round cells or primitive cytomorphology.<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/softtissuemyxoidliposarcoma.html|title=Soft tissue - Adipose tissue - Myxoid liposarcoma|author=Michael R. Clay|website=PathologyOutlines}} Topic Completed: 1 January 2018. Revised: 20 March 2019</ref> | ||
</gallery> | </gallery> | ||
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File:Pedunculated lipofibroma (intermediate magnification).jpg|Histopathology, showing thin rim of epidermis, and dermal lipocytes without capsule. | File:Pedunculated lipofibroma (intermediate magnification).jpg|Histopathology, showing thin rim of epidermis, and dermal lipocytes without capsule. | ||
</gallery> | </gallery> | ||
For atypical cases and as a non-subspecialist in soft tissue pathology, generally seek '''expert opinion''', including further workup. | |||
===Microscopy/Histopathology report=== | ===Microscopy/Histopathology report=== | ||
For lipomas: Absence of signs of malignancy. | For lipomas: {{Moderate-begin}}Absence of signs of malignancy.{{Moderate-end}} | ||
{|class="wikitable" | {|class="wikitable" | ||
| [[File:Histopathology of lipoma.jpg|190px|left]] | | [[File:Histopathology of lipoma.jpg|190px|left]] {{Moderate-begin}}Chest wall, left lateral, excision:{{Moderate-end}} | ||
{{Comprehensive-begin}}Tissue composed of univacuolar fat cells and delicate and inconspicuous fibrous septa.{{Comprehensive-end}} | *Lipoma. | ||
*{{Moderate-begin}}Negative for malignancy{{Moderate-end}} | |||
{{Comprehensive-begin}}Microscopic description: Tissue composed of univacuolar fat cells and delicate and inconspicuous fibrous septa.{{Comprehensive-end}} | |||
|} | |} | ||
{{Reporting}} | {{Reporting}} | ||
{{Bottom}} | {{Bottom}} | ||