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Intradermal spindle cell/pleomorphic lipoma: a distinct subset.

C A French¹, T Mentzel, H Kutzner

¹Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.

The American Journal of Dermatopathology

|February 24, 2001

Summary

Dermal spindle cell/pleomorphic lipomas are rare benign tumors. They present distinct features, including a female predilection and infiltrative margins, aiding differential diagnosis.

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Area of Science:

Dermatopathology
Surgical Pathology
Oncology

Background:

Spindle cell/pleomorphic lipomas are benign lipogenic tumors.
Intradermal occurrence is rare and can lead to misdiagnosis.

Purpose of the Study:

To clinicopathologically and immunohistochemically analyze intradermal spindle cell/pleomorphic lipomas.
To identify distinctive features of dermal versus subcutaneous lesions.

Main Methods:

Retrospective review of 157 spindle cell/pleomorphic lipomas, identifying 20 dermal lesions.
Clinicopathological and immunohistochemical analysis (CD34, S-100).

Main Results:

Female predilection (70%) and median age of 42 years.
Common sites: head/neck, shoulder/upper back, lower limbs.

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Dermal lesions: unencapsulated, infiltrative margins, similar cytomorphology to subcutaneous.

CD34 positive, S-100 negative in lesional cells.

One local recurrence after 21 years.

Conclusions:

Dermal spindle cell/pleomorphic lipomas exhibit unique characteristics: female predilection, wider distribution, and lack of circumscription.
These features are crucial for accurate differential diagnosis.