Verocay and Verocay-Like Bodies: Is There a Distinction? Spindle Cell Lipoma as an Example

Area of Science:

• Surgical Pathology
• Dermatopathology
• Oncology

Background:

• Spindle cell lipoma (SCL) is a benign adipocytic tumor typically found in middle-aged men.
• Unusual histologic patterns in SCL can mimic other neoplasms, posing diagnostic challenges.
• Verocay bodies are characteristic of schwannoma but can appear in other tumors.

Purpose of the Study:

• To report a case of SCL with prominent Verocay-like bodies.
• To highlight the diagnostic challenges and differential diagnosis of SCL.
• To emphasize the utility of immunohistochemistry in distinguishing SCL from schwannoma.

Main Methods:

• Histopathological examination of a SCL on the posterolateral neck.
• Immunohistochemical staining for S100, CD34, and RB protein.
• Correlation of microscopic findings with immunohistochemical results.

Main Results:

• The SCL exhibited prominent palisaded arrangements resembling Verocay bodies.
• Immunohistochemistry showed spindle cells negative for S100, positive for CD34, and with loss of nuclear RB staining.
• These findings confirmed the diagnosis of SCL and differentiated it from schwannoma.

Conclusions:

• Spindle cell lipoma can present with Verocay-like bodies, necessitating a broad differential diagnosis.
• Immunohistochemistry is essential for accurate diagnosis, particularly ruling out schwannoma.
• Careful integration of histology, immunohistochemistry, and precise terminology is crucial to avoid misdiagnosis.