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  • Print publication year: 2010
  • Online publication date: March 2011



Ordinary lipoma and its variants contain mature white fat, sometimes with fibroblastic or other mesenchymal elements. The term lipomatosis covers a heterogeneous group of entities representing regional diffuse growth of mature fat that does not have known morphologically distinctive features, except for lipomatosis of the nerve, which is discussed in more detail later.

Some lesions designated as lipomas, such as synovial lipoma with villous pattern (lipoma arborescens) and lipoma of the hernia sac, are more likely reactive hyperplasias than true neoplasms. Furthermore, lumbosacral lipoma in children is associated with neural tube closure defects and could be a developmental anomaly.

Atypical lipoma is discussed in Chapter 15 with liposarcomas, because it is essentially synonymous with well-differentiated liposarcoma.

Several special lipoma types are considered specific clinicopathologic entities, as listed previously. All of these, except angiolipoma and spindle cell lipoma, are quite rare. Hibernoma is a tumor resembling brown fat, and chondroid lipoma has some resemblance to it. Lipoblastoma is a clinically and genetically distinctive childhood lipomatous tumor. Fibrohistiocytic lipoma is a peculiar benign lipomatous tumor in the leg, having a mesenchymal fibrohistiocytic-like element.

Finally, fat atrophy, fat necrosis, sclerosing lipogranuloma silicone granuloma, and lymphedema in obese patients are discussed as examples of non-neoplastic lesions that can simulate lipomatous tumors. Angiomyolipoma is included among perivascular epithelioid cell tumors (PEComas), a group of tumors with HMB45-positive and smooth muscle actin–positive components (see Chapter 19).

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Variants of Ordinary Lipoma
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Spindle Cell, Pleomorphic, and Sclerotic Lipoma
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Chondroid Lipoma, Myolipoma, and Hemosiderotic Fibrohistiocytic Lipomatous Lesion
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Coffin, CMLipoblastoma: an embryonal tumor of soft tissue related to organogenesis. Semin Diagn Pathol 1994;11:98–103.
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Chun, YS, Kim, WK, Park, KW, Lee, SC, Jung, SE. Lipoblastoma. J Pediatr Surg 2001;36:905–907.
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Miller, GC, Yanchar, NL, Magee, JF, Blair, GK. Lipoblastoma and liposarcoma in children: an analysis of 9 cases and review of the literature. Can J Surg 1998;41:455–458.
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Fletcher, JA, Kozakewich, HP, Schoenberg, ML, Morton, CC. Cytogenetic findings in pediatric adipose tissue tumors: consistent rearrangement of chromosome 8 in lipoblastoma. Genes Chromosomes Cancer 1993;6:24–29.
Dal Cin, P, Sciot, R, DeWever, I, Damme, B, Berghe, H. New discriminative chromosomal marker in adipose tissue tumors. The chromosome 8q11-q13 region in lipoblastoma. Cancer Genet Cytogenet 1994;78:232–235.
Sawyer, JR, Parsons, EA, Crowson, ML, Smith, S, Erickson, S, Bell, JM. Potential diagnostic implications of breakpoints in the long arm of chromosome 8 in lipoblastoma. Cancer Genet Cytogenet 1994;76:39–42.
Somers, GR, Teshima, I, Nasr, A, Cook, A, Khoury, AE, Taylor, GP. Intrascrotal lipoblastoma with complex karyotype: a case report and review of the literature. Arch Pathol Lab Med 2004;128:797–800.
Astrom, A, DíAmore, ES, Sainati, L, Panarello, C, Morerio, C, Mark, J. Evidence of involvement of the PLAG1 gene in lipoblastomas. Int J Oncol 2000;16:1107–1110.
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Lipoatrophy/Lipodystrophy, Lipogranuloma, and Silicone
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Massive Localized Lymphedema
Farshid, G, Weiss, SW. Massive localized lymphedema in the morbidly obese: a histologically distinct reactive lesion simulating liposarcoma. Am J Surg Pathol 1998;22:1277–1283.
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