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spindle cell lipoma
part of histologic spectrum of spindle cell lipoma & pleomorphic lipoma.
Epidemiology:
- older men, median age over 50 yrs.
- predominantly posterior neck & shoulder
- face, forehead, scalp, buccal-perioral area, upper arm less common; lower extremity rare
Pathology: oval/discoid yellow/gray/white mass, firmer texture than ordinary lipomas
Microscopic pathology:
- variable numbers of adipocytes
- bland mitotically inactive spindle cells
- thick rope like collagen bundles
- often large numbers of mast cells
- may show myxoid stromal change or slit like spaces resembling vascular slits
Immunophenotype: CD34 strongly positive S100 may rarely be positive
Genetics:
- frequently hypodiploid
- monosomy/partial monosomy 13/16
- breakpoint chromosome 16q13 with loss of 16q13-qter
- chromosome 13q12 and 13q14-q22 losses
Clinical manifestations:
- asymptomatic, circumscribed, mobile dermal or subcutaneous mass
- long history
- usually single lesions
Management:
- benign behavior
- conservative local excision
General
adipose tissue neoplasm
References
- WHO Classification Tumours of Soft Tissue and Bone
Fletcher, Unni & Mertens Eds. IARC Press 2002
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