pleomorphic lipoma lacking mature fat componentin extensive myxoid stroma a great diagnosticchallenge多形性脂肪瘤缺乏成熟脂肪部件广泛diagnosticchallenge黏液样基质.pdfVIP

Lin et al. Diagnostic Pathology 2012, 7:155 /content/7/1/155 CASE REPORT Open Access Pleomorphic lipoma lacking mature fat component in extensive myxoid stroma: a great diagnostic challenge 1,2 1,2 1,2 3 1,2 1,2 1,2 Xu-Yong Lin , Yan Wang , Yang Liu , Ying Sun , Yuan Miao , Yong Zhang , Juan-Han Yu and En-Hua Wang1,2* Abstract Pleomorphic lipoma is a relatively uncommon entity, and is considered as a variant of spindle cell lipoma. Histologically, spindle cell lipoma/pleomorphic lipoma consists of varying quantity of mature fat, bland spindle cells and ropey collagen. In addition, pleomorphic lipoma is characterized by multinucleate giant cells, which possess the “floret-like” nuclei and marked pleomorphism. So, in contrast to spindle cell lipoma, pleomorphic lipoma is more easily misdiagnosed as a malignant tumor. Herein, we report a peculiar case of pleomorphic lipoma occurring in axilla with entirely devoid of mature fat in a 71-year-old male. The histopathological findings demonstrated the tumor was made up of bland spindle cells admixed with scattered “floret-like” cells and irregular ropey collagen in an extensive myxoid stroma. Immunostaining showed that the tumor was positive for the Vimentin, Bcl-2 and CD34, and was negative for S-100, desmin, CD68, and α–SMA. Although no fat component was found in the whole section, the tumor was still diagnosed as a pelomprphic lipoma. To our knowledge, this is the third reported case of pelomprphic lipoma which entirely lacked lipomatous component. Because of the existence of atypical multinucleate giant cells and lack of mature fat, this tumor may be easily misdiagnosed nonlipomatous lesions, such as myxoid fibrosarcoma, giant cell fibrob