Lipomatous tumor: Difference between revisions

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{{Fixation - standard}}
{{Fixation - standard}}
{{Fixation - general notes}}
{{Fixation - general notes}}
==Comprehensiveness==
{{Comprehensiveness}}
==Gross processing==
==Gross processing==
*Perform consecutive '''slicing''' of the entire specimen.
*Perform consecutive '''slicing''' of the entire specimen.
*Look for signs of '''liposarcoma''': Mainly by firm volumes.<ref>{{Lilla utskärningen}}</ref> Color varies from yellow to white (and firm) depending on the proportion of adipocytic, fibrous and/or myxoid content.<ref name=Mavrogenis2013>{{cite web|url=http://atlasgeneticsoncology.org/Tumors/WellDiffLiposarcomaID5167.html|title=Soft Tissues: Well-differentiated liposarcoma|author=Andreas F Mavrogenis, Panayiotis J Papagelopoulos|date=2013-02-01|website=Atlas of Genetics and Cytogenetics in Oncology and Haematology}}</ref> Areas of fat necrosis are common in larger lesions. Rarely, infiltrative growth is seen.<ref name=Mavrogenis2013/>
*Look for signs of '''liposarcoma''': Mainly by firm volumes.<ref>{{Lilla utskärningen}}</ref> Color varies from yellow to white (and firm) depending on the proportion of adipocytic, fibrous and/or myxoid content.<ref name=Mavrogenis2013>{{cite web|url=http://atlasgeneticsoncology.org/Tumors/WellDiffLiposarcomaID5167.html|title=Soft Tissues: Well-differentiated liposarcoma|author=Andreas F Mavrogenis, Panayiotis J Papagelopoulos|date=2013-02-01|website=Atlas of Genetics and Cytogenetics in Oncology and Haematology}}</ref> Areas of fat necrosis are common in larger lesions. Rarely, infiltrative growth is seen.<ref name=Mavrogenis2013/>
*'''Submit''' slices from any suspicious parts, or at least one representative slice from the specimen.<ref>{{NU Hospital Group}}</ref> A more comprehensive practice is to submit 1 section per centimeter, and 2 sections per cassette.<ref>{{cite web|url=https://voices.uchicago.edu/grosspathology/bone-soft-tissue/lipoma/|title=Lipoma|website=Gross Pathology Manual - By The University of Chicago Department of Pathology|accessdate=2020-08-26}}</ref>
*'''Submit''' slices from any suspicious parts, or at least one representative slice from the specimen.<ref>{{NU Hospital Group}}</ref> {{Moderate-begin}}A more comprehensive practice is to submit 1 section per centimeter, and 2 sections per cassette.<ref>{{cite web|url=https://voices.uchicago.edu/grosspathology/bone-soft-tissue/lipoma/|title=Lipoma|website=Gross Pathology Manual - By The University of Chicago Department of Pathology|accessdate=2020-08-26}}</ref>{{Moderate-end}}
<gallery mode=packed heights=200>
<gallery mode=packed heights=200>
File:Lipoma gross.jpg|thumb|Cross-section of '''lipoma'''. Homogenous texture.
File:Lipoma gross.jpg|thumb|Cross-section of '''lipoma'''. Homogenous texture.
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Example:
Example:
{|class="wikitable"
{|class="wikitable"
| Mass weighing 121 grams and measuring 10 x 6,5 x 3,5 cm. Homogenous yellow color. No hemorrhage or necrosis.
| Mass {{Comprehensive-begin}}weighing 121 grams{{Comprehensive-end}} and measuring 10 x 6,5 x 3,5 cm. {{Comprehensive-begin}}The surgical margin is intact.{{Comprehensive-end}} Cut sections show homogenous yellow color, with no hemorrhage or necrosis. {{Comprehensive-begin}}The specimen is serially sectioned, and representative sections are submitted for microscopic examination in __ cassettes.{{Comprehensive-end}}
|}
|}
{{Gross processing}}
{{Gross processing}}
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{|class="wikitable"
{|class="wikitable"
| [[File:Histopathology of lipoma.jpg|190px|left]]
| [[File:Histopathology of lipoma.jpg|190px|left]]
Tissue composed of univacuolar fat cells and delicate and inconspicuous fibrous septa. No evidence of malignancy.<br>-Lipoma.
{{Comprehensive-begin}}Tissue composed of univacuolar fat cells and delicate and inconspicuous fibrous septa.{{Comprehensive-end}} No evidence of malignancy.<br>-Lipoma.
|}
|}
{{Reporting}}
{{Reporting}}
{{Bottom}}
{{Bottom}}

Revision as of 17:46, 26 August 2020

Author: Mikael Häggström [note 1]

File:Lipoma 06.jpg
Lipomatous tumor.

Fixation

Generally 10% neutral buffered formalin.

  See also: General notes on fixation


Comprehensiveness

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross processing

  • Perform consecutive slicing of the entire specimen.
  • Look for signs of liposarcoma: Mainly by firm volumes.[1] Color varies from yellow to white (and firm) depending on the proportion of adipocytic, fibrous and/or myxoid content.[2] Areas of fat necrosis are common in larger lesions. Rarely, infiltrative growth is seen.[2]
  • Submit slices from any suspicious parts, or at least one representative slice from the specimen.[3] (A more comprehensive practice is to submit 1 section per centimeter, and 2 sections per cassette.[4])
  • Cross-section of lipoma. Homogenous texture.
    Cross-section of lipoma. Homogenous texture.
  • Liposarcoma: Tumor section reveals brownish-yellowish areas, hemorrhagic and calcific zones.
    Liposarcoma: Tumor section reveals brownish-yellowish areas, hemorrhagic and calcific zones.

Gross report

  • Color
  • Even absence of hemorrhage or necrosis.

Example:

Mass ((weighing 121 grams)) and measuring 10 x 6,5 x 3,5 cm. ((The surgical margin is intact.)) Cut sections show homogenous yellow color, with no hemorrhage or necrosis. ((The specimen is serially sectioned, and representative sections are submitted for microscopic examination in __ cassettes.))

  See also: General notes on gross processing


Microscopic evaluation

  • Lipoma: lobules of mature white adipose tissue divided by delicate and inconspicuous fibrous septa containing thin-walled capillary-sized vessels.
    Lipoma: lobules of mature white adipose tissue divided by delicate and inconspicuous fibrous septa containing thin-walled capillary-sized vessels.
  • Fibrolipoma is a lipoma with focal areas of large amounts of fibrous tissue. A sclerotic lipoma is one step further: a predominantly fibrous lesion with focal areas of fat.[5] If unsure of degree of fibrosis: Simply report as lipoma.
    Fibrolipoma is a lipoma with focal areas of large amounts of fibrous tissue.
    A sclerotic lipoma is one step further: a predominantly fibrous lesion with focal areas of fat.[5]
    If unsure of degree of fibrosis: Simply report as lipoma.
  • Myxoid liposarcoma: Hypercellular solid sheets of cells lying back to back, with round cells or primitive cytomorphology.[6]
    Myxoid liposarcoma: Hypercellular solid sheets of cells lying back to back, with round cells or primitive cytomorphology.[6]

A pedunculated lipomatous skin tumor may be a pedunculated lipofibroma:

Microscopy/Histopathology report

For lipomas: Absence of signs of malignancy.

Error creating thumbnail:

((Tissue composed of univacuolar fat cells and delicate and inconspicuous fibrous septa.)) No evidence of malignancy.
-Lipoma.

  See also: General notes on reporting


Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg (1997-02-13). Lilla utskärningen.
  2. ↑ 2.0 2.1 Andreas F Mavrogenis, Panayiotis J Papagelopoulos (2013-02-01). Soft Tissues: Well-differentiated liposarcoma. Atlas of Genetics and Cytogenetics in Oncology and Haematology.
  3. ↑ Pathology Department at NU Hospital Group, Sweden, 2019-2020.
  4. ↑ . Lipoma. Gross Pathology Manual - By The University of Chicago Department of Pathology. Retrieved on 2020-08-26.
  5. ↑ . Lipoma Variant: Fibrolipoma. Stanford University School of Medicine. Retrieved on 2020-02-10.
  6. ↑ Michael R. Clay. Soft tissue - Adipose tissue - Myxoid liposarcoma. PathologyOutlines. Topic Completed: 1 January 2018. Revised: 20 March 2019

Image sources


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