Hemosiderotic Fibrohistiocytic Lipomatous Lesion
Differential Diagnosis
Combination of bland spindle cells and fat
- Dermatofibrosarcoma protuberans
- Fibromatosis
- Atypical lipomatous tumor
- Spindle cell lipoma
- Hemosiderotic fibrolipomatous lesion
Combination of spindle cells, histiocytes and multinucleated cells
| Hemosiderotic Fibrohistiocytic Lipomatous Lesion | Dermatofibrosarcoma Protuberans |
|---|---|
| Fat forms mass | Infiltrates fat peripherally |
| Septal spindle cells | Storiform pattern |
| Abundant hemosiderin | Lacks hemosiderin |
| Hemosiderotic Fibrohistiocytic Lipomatous Lesion | Fibromatosis |
|---|---|
| Fat forms the mass | Infiltrates fat |
| Abundant hemosiderin | Lacks hemosiderin |
| Inflammation present | Lacks inflammation |
| Hemosiderotic Fibrohistiocytic Lipomatous Lesion | Atypical Lipomatous Tumor, Spindle Cell Variant |
|---|---|
| Uniform size of adipocytes | Variably sized adipocytes |
| No lipoblasts | Lipoblasts in most cases |
| No significant atypia | Large atypical cells |
| Hemosiderotic Fibrohistiocytic Lipomatous Lesion | Spindle Cell Lipoma |
|---|---|
| Predominantly on foot and ankle | Predominantly restricted to back of neck, upper back and shoulder |
| Lacks ropy collagen bundles | Ropy collagen bundles |
| Abundant hemosiderin | Lacks hemosiderin |
| Hemosiderotic Fibrohistiocytic Lipomatous Lesion | Lipofibromatosis |
|---|---|
| Circumscribed | Poorly circumscribed |
| Prominent hemosiderin | Lacks hemosiderin |
| Includes histiocytes and other inflammatory cells | Histiocytes and inflammation not integral to lesion |
| Occasional floret cells | Lacks floret cells |
