Lipomatous tumor: Difference between revisions
Jump to navigation
Jump to search
Organized |
→Microscopic evaluation: Generally |
||
| (6 intermediate revisions by the same user not shown) | |||
| Line 29: | Line 29: | ||
<gallery mode=packed heights=220> | <gallery mode=packed heights=220> | ||
File:Histopathology of lipoma.jpg|'''Lipoma''': lobules of mature white adipose tissue divided by delicate and inconspicuous fibrous septa containing thin-walled capillary-sized vessels. Still, look close at the fibrous septa: | File:Histopathology of lipoma.jpg|'''Lipoma''': lobules of mature white adipose tissue divided by delicate and inconspicuous fibrous septa containing thin-walled capillary-sized vessels. Still, look close at the fibrous septa: | ||
File:Histopathology of an atypical lipomatous tumor or well-differentiated liposarcoma, lipoma-like subtype.jpg|An '''atypical lipomatous tumor''' (also termed '''well-differentiated liposarcoma'''), lipoma-like subtype. At low magnification, the majority of the tumor has the look of benign mature adipocytes, but | File:Histopathology of an atypical lipomatous tumor or well-differentiated liposarcoma, lipoma-like subtype.jpg|An '''atypical lipomatous tumor''' (also termed '''well-differentiated liposarcoma'''), lipoma-like subtype. At low magnification, the majority of the tumor essentially has the look of benign mature adipocytes (except for mildly increased variation in lipid droplet sizes), but high magnification of a fibrous band shows spindle cells with enlarged, hyperchromatic nuclei. Another clue for liposarcoma is a higher variability of lipid droplet sizes. | ||
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> | ||
| Line 40: | Line 41: | ||
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}} | ||