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Membranous fat necrosis in lipomas

P K Ramdial1, A Madaree, B Singh

  • 1Department of Anatomical Pathology, Faculty of Medicine, University of Natal, Republic of South Africa.

The American Journal of Surgical Pathology
|July 1, 1997
PubMed
Summary

Membranous fat necrosis (MFN), a rare variant of fat necrosis, was identified in four large lipomas. Histologic and histochemical analysis revealed these foci resemble ceroid pigment, suggesting potential traumatic or ischemic causes.

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Area of Science:

  • Pathology
  • Surgical Oncology
  • Dermatopathology

Background:

  • Membranous fat necrosis (MFN) is a rare variant of fat necrosis.
  • MFN typically occurs in systemic adipose tissue.
  • MFN has not been previously described in lipomas.

Purpose of the Study:

  • To report the occurrence of MFN in lipomas.
  • To characterize the histologic and histochemical features of MFN in lipomas.
  • To propose potential etiologies for MFN in lipomas.

Main Methods:

  • Case series of four lipomas with MFN.
  • Macroscopic and histologic examination.
  • Histochemical staining (Sudan black, PAS, Ziehl-Neelsen) and immunofluorescence.

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Main Results:

  • MFN was identified in four large lipomas (9-22 cm) from menopausal women.
  • Membranocystic foci were macroscopically visible in two cases and only histologically in others.
  • MFN membranes showed Sudan black positivity, PAS or Ziehl-Neelsen positivity, and autofluorescence, consistent with ceroid pigment.

Conclusions:

  • This study describes the novel finding of MFN within lipomas.
  • The membranocystic foci in lipomas share histochemical characteristics with ceroid pigment.
  • Large size, trauma, or ischemia are proposed as potential causes for MFN in lipomas.