Surgical Pathology Criteria–

Lipoma

Variant: Myxolipoma / Angiomyxolipoma

Diagnostic Criteria

Lipoma with prominent myxoid areas
Must not contain lipoblasts
If richly vascular, termed angiomyxolipoma
- Thin and thick walled vessels
- May be dilated

Supplemental Studies

Spindle cells in myxoid areas
- Positive for CD34
- Negative for S100, smooth muscle actin, desmin
Genetic studies have shown t(7;13) and t(8;12)

Differential Diagnosis

Myxoid Liposarcoma	Myxolipoma / Angiomyxolipoma
Prominent "chicken wire" vascular pattern	Lacks "chicken wire" vascular pattern
May have lipoblasts	Lacks lipoblasts
Very rare in subcutis or dermis	Usually in subcutis or dermis
CD34 negative or scattered small cells	CD34 widely positive in myxoid areas
t(12;16) or t(12;22)	t(7;13) or t(8;12) reported

Myxolipoma	Spindle Cell Lipoma with Myxoid Stroma
Lacks prominent spindle cell component	Prominent spindle cell component
May have prominent vascularity	Vascularity rarely prominent
No dense collagen bundles	Dense ropy collagen bundles
Location variable	Largely restricted to back, shoulders, posterior neck

Clinical

No clinical significance to this pattern

Bibliography

Lee HW, Lee DK, Lee MW, Choi JH, Moon KC, Koh JK. Two cases of angiomyxolipoma (vascular myxolipoma) of subcutaneous tissue. J Cutan Pathol. 2005 May;32(5):379-82.
Tardio JC, Martin-Fragueiro LM. Angiomyxolipoma (vascular myxolipoma) of subcutaneous tissue. Am J Dermatopathol. 2004 Jun;26(3):222-4.

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