World Journal of Surgical Oncology | |
A case of ‘fat-free’ pleomorphic lipoma occurring in the upper back and axilla simultaneously | |
En-Hua Wang1  Na Tang1  Yong Zhang1  Di Zhang1  Yang Liu1  Liang Wang1  | |
[1] Institute of pathology and pathophysiology, China Medical University, North 2nd Road, 92#, Shenyang 110001, China | |
关键词: Pleomorphic hyalinizing angiectatic tumor; Myxoid liposarcoma; Atypical lipomatous tumor; Pleomorphic lipoma; Spindle cell lipoma; | |
Others : 823776 DOI : 10.1186/1477-7819-11-145 |
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received in 2013-01-05, accepted in 2013-06-16, 发布年份 2013 | |
【 摘 要 】
Pleomorphic lipoma is a rare neoplasm that predominantly occurs in the dermis or subcutis of the posterior neck, upper back, and shoulders. Although pleomorphic lipoma is a benign tumor, it may contain atypical cells. As a variant of spindle cell lipoma, pleomorphic lipoma clinically presents as a slow-growing and well-circumscribed subcutaneous mass. Rarely, some patients have multiple lesions. Histologically, pleomorphic lipoma is composed of mature fat, bland spindle-shaped mesenchymal cells, and coarse ‘rope-like’ collagen bands. In addition, lipoma contains multinucleated floret-like giant cells. Although spindle cell lipoma/pleomorphic lipoma with little fat was seen in the original series described by Enzinger and Harvey, cases with little to no fat remain diagnostically challenging. Herein, we report a case of ‘fat-free’ pleomorphic lipoma occurring in the upper back and axilla simultaneously. Although the lipoma was typically composed of bland spindle-shaped cells, rope-like collagen, scattered floret-like giant cells, and striking stromal myxoid change in the background, mature fat was absent. Immunohistochemical analyses showed positive staining for CD34, vimentin, and Bcl-2, and negative staining for S100, confirming the diagnosis of pleomorphic lipoma.
【 授权许可】
2013 Wang et al.; licensee BioMed Central Ltd.
【 预 览 】
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20140713013641630.pdf | 1779KB | download | |
Figure 2. | 177KB | Image | download |
Figure 1. | 271KB | Image | download |
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【 参考文献 】
- [1]Miettinen M: Modern Soft Tissue Pathology: Tumors and Non-Neoplastic Conditions. New York, NY: Cambridge University Press; 2010.
- [2]Hayashi T, Tsuda N, Shimada O, Maeda H: A pleomorphic lipoma of the palm–comparison to spindle cell lipoma. Gan No Rinsho 1989, 35:437-441.
- [3]Singh N, Dabral C, Singh PA, Singh M, Gupta SC, Jain S: Pleomorphic lipoma of the tonsillar fossa–a case report. Indian J Pathol Microbiol 2003, 46:476-477.
- [4]Daniel CS, Beaconsfield M, Rose GE, Luthert PJ, Heathcote JG, Clark BJ: Pleomorphic lipoma of the orbit: a case series and review of literature. Ophthalmology 2003, 110:101-105.
- [5]Atik E, Usta U, Aydin NE: Pleomorphic lipoma of the tongue. Otolaryngol Head Neck Surg 2002, 126:430-431.
- [6]Reis-Filho JS, Milanezi F, Soares MF, Fillus-Neto J, Schmitt FC: Intradermal spindle cell/pleomorphic lipoma of the vulva: case report and review of the literature. J Cutan Pathol 2002, 29:59-62.
- [7]Perrotti V, Rubini C, Fioroni M, Iezzi G: Pleomorphic lipoma of the oral cavity. Report of a case. Minerva Stomatol 2006, 55:321-325.
- [8]Austin CD, Tiessen JR, Gopalan A, Williams JM Jr, Bangs CD, Cherry AM, Lehnert BA, Rouse RV: Spindle cell lipoma of the foot and the application of CD34 immunohistochemistry to atypical lipomatous tumors in unusual locations. Appl Immunohistochem Mol Morphol 2000, 8:222-227.
- [9]Hattori H: Atypical lipomatous tumor of the lip with pleomorphic lipoma-like myxoid area, clinically simulating mucocele. J Oral Pathol Med 2002, 31:561-564.
- [10]Shmookler BM, Enzinger FM: Pleomorphic lipoma: a benign tumor simulating liposarcoma. A clinicopathologic analysis of 48 cases. Cancer 1981, 47:126-133.
- [11]Sachdeva MP, Goldblum JR, Rubin BP, Billings SD: Low-fat and fat-free pleomorphic lipomas: a diagnostic challenge. Am J Dermatopathol 2009, 31:423-426.
- [12]Enzinger FM, Harvey DA: Spindle cell lipoma. Cancer 1975, 36:1852-1859.
- [13]Azzopardi JG, Iocco J, Salm R: Pleomorphic lipoma: a tumour simulating liposarcoma. Histopathology 1983, 7:511-523.
- [14]Brcic L, Jakovcevic A, Vuletic LB, Orlic D, Seiwerth S: Pleomorphic liposarcoma of the foot: a case report. Diagn Pathol 2008, 3:15. BioMed Central Full Text
- [15]Tardio JC, Aramburu JA, Santonja C: Desmin expression in spindle cell lipomas: a potential diagnostic pitfall. Virchows Arch 2004, 445:354-358.
- [16]Weiss SW, Enzinger FM: Myxoid variant of malignant fibrous histiocytoma. Cancer 1977, 39:1672-1685.
- [17]Fletcher CD: Giant cell fibroblastoma of soft tissue: a clinicopathological and immunohistochemical study. Histopathology 1988, 13:499-508.
- [18]Billings SD, Folpe AL: Diagnostically challenging spindle cell lipomas: a report of 34 “low-fat” and “fat-free” variants. Am J Dermatopathol 2007, 29:437-442.