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dermal spindle cell lipoma

Thursday 27 June 2019

Definition : Dermal spindle cell lipoma characterized by a mixture of mature adipocytes and spindle-shaped cells in a fibromucinous background.

Some lesions can show a moderately well circumscribed plexiform pattern, or a well demarcated nodular pattern with compression of surrounding connective tissue and prominent stromal fibrosis.

Clinically, the plexiform type mostly occurred in the thigh-groin-buttock area and the nodular type in the head-neck or acral location.

While plexiform lesions are predominantly seen in middle-aged females, nodular types occurr in young adults of either sex.

In a series, no recurrence was seen in five patients with follow-up.

The tumour cells are vimentin positive and a thin cytomplasmic rim of S-100 protein positivity can be seen in mature adipocytes.

Ultrastructural studies reveal lipoblastic differentiation of spindle-shaped cells with lipid droplets and basal lamina formation.

Dermal spindle cell lipomas seem to be the dermal counterpart of the most subcutaneously located spindle cell lipoma.

References

- Dermal spindle cell lipoma: plexiform and nodular variants. Zelger BW, Zelger BG, Plörer A, Steiner H, Fritsch PO. Histopathology. 1995 Dec;27(6):533-40. PMID: 8838333