Surgical Pathology Criteria

Hibernoma

Differential Diagnosis

Fat Necrosis Hibernoma
Poorly circumscribed Circumscribed
Foamy cytoplasm, few vacuoles Multiple small vacuoles
Variable pattern from normal fat to necrotic fat to histiocytes Uniform pattern

Lipoblastoma Hibernoma
Restricted to children at presentation Rare in children
Immature cells and lipoblasts Microvesicular brown fat
8q11-13 abnormalities 11q13 abnormalities

Hibernoma with predominant mature fat Atypical Lipomatous Tumor
Small, central bland nuclei in vacuolated cells Lipoblasts, if present, have atypical nuclei
Lacks atypical nuclei Contains atypical nuclei
Frequently superifcial Rarely superficial
MDM2, CDK4, p16 negative MDM2, CDK4, p16 most positive

Myxoid Liposarcoma Hibernoma with Myxoid Stroma
Rarely superficial Frequently superficial
Prominent "chicken wire" vascular pattern Lacks "chicken wire" vascular pattern
t(12;16) or t(12;22) 11q13 rearrangement

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