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PubMed1995

Spindle cell lipomas. A report of two cases: one with multiple lesions.

BACKGROUND: Spindle cell lipoma is an unusual and histologically distinctive form of lipoma occurring primarily in older individuals. OBJECTIVE: The dermatologic surgeon and pathologist should be familiar with this variant of lipoma. METHODS: We are reporting two cases of spindle cell lipomas with the results of histologic examination with special stains and immunohistochemical studies. RESULTS: The neoplasms consisted of lobulated masses of mature adipose tissue with areas of spindle cell proliferation. There was strong positive staining with antibodies for vimentin within the areas of spindle cells proliferation. One of the cases is unusual in that multiple lesions are occurring in a young patient. CONCLUSION: Recognition of the histologic pattern is important in distinguishing the benign spindle cell lipoma from the malignant liposarcoma.

Adipose Tissue↗
PubMedDate not supplied

Solitary choroid plexus lipomas: CT and MR appearance.

Using MR imaging, the authors detected 23 cases of intracranial lipomas, among which were three cases of solitary choroid plexus lipomas. All the lipomas were located in the choroid plexus at the trigone. One of the three solitary choroid plexus lipomas was very small and could not be detected using CT. The authors believe that solitary choroid plexus lipomas are not as rare as was previously thought.

Adult↗
PubMed1993

Chromosome 12 breakpoints are cytogenetically different in benign and malignant lipogenic tumors: localization of breakpoints in lipoma to 12q15 and in myxoid liposarcoma to 12q13.3.

Cytogenetic study of short-term cultures from 10 adipose tissue tumors (eight lipomas, one myxoid liposarcoma, and one mixed liposarcoma) have revealed clonal chromosome abnormalities in seven cases. In both malignant tumors, translocation (12;16) was the sole aberration, and in the mixed liposarcoma, the breakpoints could be sublocalized to bands 12q13.3 and 16p11.2, thus confirming findings of Eneroth et al., Cancer Genet. Cytogenet., 48: 101-107, 1990. Three lipomas displayed predominantly normal karyotypes; in a fourth case, the karyotype 44,XX,-6,der (7)t(6;7)(p21.3-22;p22)ins(7)(p22q11.2q22),-13 was found. Four remaining lipomas were characterized by structural rearrangements of chromosome 12. We were able to achieve high resolution banding patterns in two tumors with translocations (3;12)(q28;q15) and (1;2;12)(p36.;q13;q15). In both of these cases, the chromosome 12 breakpoint could be unequivocally assigned to band q15. Similarly, band 12q15 was also rearranged in two other lipomas with translocations (12;14)(q15;q32) and (12;20)(q15;q13.1). Our results support the hypothesis that the chromosome 12 breakpoint in lipomas is located more distally than the breakpoint in myxoid liposarcomas and some other soft-tissue malignant neoplasms and that it is cytogenetically identical with breakpoints detected in such benign tumors as uterine leiomyoma and pleomorphic adenoma of the salivary gland.

Adult↗
PubMed1996

Lipomas of the internal auditory canal.

Lipoma of the internal auditory canal is a rare tumor that may be confused clinically with the much more common vestibular schwannoma. We present two cases of lipoma of the internal auditory canal. The clinical presentation is indistinguishable from that of vestibular schwannomas. The high signal intensity on T1-weighted magnetic resonance imaging, both with and without contrast, is consistent with other reports of lipoma. Review of the literature shows that lipomas of the internal auditory canal are histopathologically similar to lipomas of the cerebellopontine angle. The symptoms, erosive effect on the auditory canal, and gross appearance of this uncommon tumor are sometimes difficult to differentiate from those of a vestibular schwannoma. The diagnosis can be established by intraoperative examination of frozen sections.

Adult↗
PubMed1996

[Intestinal invagination caused by colonic lipoma].

The observation of a case of intestinal intussusception caused by lipoma of the colon prompted the authors to review the literature on the subject and to examine the main characteristics of lipoma of the colon which represent the most frequent benign neoplasia of the large intestine after adenomatous polyps. Lipomas of the colon are localised in 90% of cases at the submucous level, are usually solitary, of varying size and may be sessile or pedunculated. They are almost always asymptomatic; only when they are of a reasonable size do they become manifest following alterations of the alveus, rectorrhagia, abdominal pain or the occupation of the colic lumen by the mass, or intestinal intussusception caused by the progression of the pedunculated lipoma. This difficult diagnosis may be aided by colonscopy with biopsy and dual contrast opaque enema. The prognosis of the disease depends on the presence or absence of complications and, in the case of the former, on early diagnosis and treatment. Lipoma of the colon of less than 2 cm may be electively removed endoscopically, those greater than 2 cm by laparotomy or laparoscopy. In emergency cases, it is advisable to perform a more or less extensive resection of the colon depending on the size of the tumour. In the case reported by the authors, an intussusception manouevre was first performed followed by left segmentary colectomy.

Adult↗
PubMed1996

[Clinical analysis of diagnosis and treatment of 44 cases with intraspinal lipoma].

44 cases of intraspinal lipoma were confirmed by pathologic examination. We excised the lipomas totally or partly. After surgery, 8 cases improved greatly, 19 cases improved, 18 not improved. CT scan and MRI are the key methods for diagnosis of intraspinal lipoma, most of intraspinal lipomas are adherent to the spine and root of nerves tightly and difficult to be dissected. So it's not easy to excise the lipoma entirely. But if we use microsurgery we can get better results.

Adolescent↗
PubMed1998

[An adult case of intrathoracic chest wall type lipoma by VATS resection].

A 48-year-old woman without symptoms was pointed out an abnormal shadow on chest X-ray film taken at the mass survey. Image diagnosis led to intrathoracic chest wall type lipoma. The tumor was surgically removed by video assisted thoracoscopic surgery (VATS), and the diagnosis of lipoma pathohistologically. VATS resection was an useful procedure for intrathoracic lipoma because VATS itself must be less invasive and lipoma was not invasive. CT and MRI were useful for evaluation of extent of tumor, but not effective for differential diagnosis of liposarcoma from lipoma. So surgical resection by VATS should be considered, if possible.

Endoscopy↗
PubMed1998

[Endobronchial lipoma: apropos of a case with dual localization].

Endobronchial lipoma is an uncommon benign tumor. It is composed of fat tissue and is visible on CT scanner. We report an unusual case of a patient who developed two endobronchial lipomas. The first lipoma was removed 10 years earlier. We emphasize the contribution of computed tomography in the diagnosis of endobronchial lipoma. Cases of multiple lipomas are very scarce in the literature.

Bronchial Neoplasms↗
PubMed2005

Lipoma arborescens affecting multiple joints.

Lipoma arborescens is a rare benign intra-articular lesion of unknown etiology that usually involves the suprapatellar pouch of the knee joint. Clinically, the most common finding is a slow-growing painless swelling, accompanied by intermittent effusion of the joint. We report a case of a multifocal lipoma arborescens localized in the knees and the hips in a 24-year-old man, initially mimicking an inflammatory arthropathy. The diagnosis of lipoma arborescens was made by magnetic resonance imaging of the hips and the knees. Under arthroscopic guidance, the synovial biopsy of the right knee disclosed the specific histological signs of lipoma arborescens. As far as we know, this is the third case of multifocal lipoma arborescens reported in the English literature.

Adult↗
PubMed1988

Consistent involvement of band 12q14 in two different translocations in three lipomas from the same patient.

We studied cytogenetically three distinct lipomas from a patient with multiple subcutaneous lipomas in the left shoulder area. A breakpoint at 12q14 was involved in structural rearrangements in the three lipomas resulting in two different reciprocal translocations, i.e., t(3;12)(q28;q14) in two and a t(1;12)(q34.2;q14) in the third. These results confirm the consistency of involvement of the breakpoint at 12q14 in lipomas and give support to the hypothesis that multiple lipomas evolve from different stem cells.

Chromosome Banding↗
PubMed2001

Multiple lipomas linked to an RB1 gene mutation in a large pedigree with low penetrance retinoblastoma.

Hereditary predisposition to lipomas is observed in familial multiple lipomatosis (OMIM 151900) and benign cervical lipomatosis (OMIM 151800) and can also be associated with mutations in the MEN1 and PTEN genes (OMIM 131100 and 153480, respectively). In addition, a recent report indicates that a few patients with hereditary retinoblastoma also have lipomas. Here we report on an extended family segregating a splice site mutation in the RB1 gene. Almost all adult carriers of this mutation had multiple lipomas while penetrance for retinoblastoma was incomplete. In an unrelated pedigree, which was reported previously, the identical mutation was only associated with low-penetrance retinoblastoma but not lipomas. Our data indicate that lipoma predisposition in hereditary retinoblastoma is not associated with specific RB1 gene mutations but is influenced by modifying factors linked to this gene.

Base Sequence↗
PubMed2004

Sliding lipoma: an indirect inguinal hernia without a peritoneal sac.

With the increasing application of endoscopic hernioplasty, surgeons have now recognized that the peritoneal sac is sometimes absent in patients who present with a reducible inguinal hernia. Sliding lipoma refers to a sliding herniation of preperitoneal fat into the inguinal canal forming a reducible indirect inguinal hernia in the absence of a peritoneal sac. In this report, we describe a patient who underwent bilateral endoscopic totally extraperitoneal inguinal hernioplasty (TEP), followed by an early recurrence of left inguinal hernia, secondary to a sliding lipoma. Sliding lipoma is a challenging condition specific to endoscopic repair of inguinal hernia. All lipomas should be reduced and excised whenever feasible. Awareness and appropriate management of the sliding lipoma will help to reduce the risk of recurrence after endoscopic hernioplasty.

Adipose Tissue↗
PubMed1979

Spindle cell lipoma of the orbit.

A 42-year-old woman had an orbital mass lesion removed surgically that proved histologically to be a spindle cell lipoma. To our knowledge, this is the first reported case of a spindle cell lipoma arising in the orbit. This specific type of lipoma occurs chiefly in male patients and is believed to affect the shoulder and posterior neck regions almost exclusively. Spindle cell lipomas, while having unusual features histologically, are benign and should not be mistaken for liposarcomas or other spindle cell soft-tissue tumors.

Adult↗
PubMed1986

Recurrent infiltrating lipoma of the head and neck. Case report and literature review.

Lipomatous tumors with intramuscular infiltration are uncommon in the head and neck. Oral lipomas have been recorded in the literature; however, infiltration and recurrence have rarely been documented. We describe a case of an oral lipoma that did not have microscopic characteristics of malignancy, lipoblastomatosis, or atypia, but which showed intramuscular invasion and recurred twice after surgery. Although certain characteristics distinguish our case from congenital lipomatosis, the clinical picture is quite similar. Lipomas with intramuscular invasion uniformly tend to recur when they are not widely resected, whether in the trunk and extremities or in the head and neck. These lesions can rapidly enlarge and infiltrate local tissues, and they require wide resection with an attempt at preservation of important structures. Preoperatively, computed tomographic analysis allows a lipoma to be diagnosed by its low attenuation, and a grossly infiltrating tumor can be distinguished from the ordinary well-encapsulated lesion.

Child, Preschool↗
PubMed1982

Ultrastructure of lipoma.

Eleven benign lipogenic tumors comprising ten ordinary lipomas and one fibroblastic lipoma were studied by light and electron microscopy. The former, which contained only a few inconspicuous septa, were composed of univacuolar mature adipocytes. No young forms of adipocytic differentiation were seen reflecting the slow growth of the ordinary lipomas. Small spindle cells accompanying capillaries located in the triangular confluence of the adipocytes are thought to be potential precursors of adipocytes. By contrast, the fibroblastic lipoma contained many younger forms which closely resembled those seen during maturation of normal adipose tissue. These younger forms are located in and about prominent trabeculae which therefore are considered to constitute active growth centers.

Adult↗
PubMed1995

'Squeeze delivery' excision of subcutaneous lipoma related to anatomic site.

A small cosmetic incision followed by 'squeeze delivery' was attempted for 190 lipomas in 116 patients. This technique was successful without resort to widening of the incision or using scissor dissection in 87 lipomas (46 per cent). Success was not related to size but to the site of the lipoma. The success rate was 100 per cent for excision of lipomas in the forearm and leg.

Adolescent↗
PubMed1989

Spindle cell and pleomorphic lipoma: an immunohistochemical study and histogenetic analysis.

Twenty-two spindle cell lipomas and seven pleomorphic lipomas were investigated immunohistochemically in order to study the differentiation of the non-adipocytic elements. In all cases, neither spindle cells nor pleomorphic cells reacted with antibodies to a monocyte/macrophage antigen (MAC-387), fibronectin, laminin or type IV collagen. The absence of demonstrable basement membrane material argues against the possible prelipoblastic nature of these cells. With the antibody to S-100 protein, spindle cells were immunonegative, whereas pleomorphic cells sometimes revealed an intracytoplasmic weak to moderate staining reaction. In the light of what is known about the development of adipose tissue, our results would support the hypothesis of Bolen and Thorning (Am J Surg Pathol 1981; 5: 435-441) that spindle cell lipoma is composed of adipocytes and non-fat storing immature mesenchymal cells. It would appear that pleomorphic lipoma is similarly derived but that in some cases adipocytic differentiation is also abnormal. The characteristic clinical distribution of these two types of tumour may be of relevance in determining the cause of these unusual benign patterns of differentiation.

Adult↗
PubMed1988

Lumbosacral lipomas with spina bifida.

The pathological and metabolic characteristics, as well as the anatomical and functional evolution of lumbosacral lipomas, were studied in a series of 73 patients operated on between 1970 and 1983. The pathological study showed that they are mainly composed of adipocytes, but that they also possess fibrous tissue, vessels, and nerve fibers. Innervated muscle fibers, contracting under proper nerve stimulation, were found in several cases. Lipogenesis and lipolysis are the same in lumbosacral lipomas and in normal fat tissue. However, these lipomas can grow with the rest of the fatty pool. Moreover, spontaneous progressive worsening of the clinical status has been observed in 36% of the cases. Surgery is efficient and not harmful to the patient. Postoperative mortality was nil. Early postoperative worsening occurred in 2.7% of the cases. The 6% rate of late postsurgical deteriorations should be compared to the 36% to 56% rate found when patients are not operated on. Three different mechanisms are responsible for clinical worsening: compression or stretching of the cord, and cord injury on the posterior upper limit of the spinal defect. In each case, one mechanism is prevalent. Three different types of lumbosacral lipomas can thus be individualized. The surgical implications of these data are discussed. The necessity for early and systematic surgical treatment is pointed out.

Adult↗