Surgical Pathology Criteria

Lipoma

Variant: Sclerotic Lipoma / Fibroma-like Lipoma

Diagnostic Criteria

Supplemental Studies

 

CD99 rare to many
CD34 neg to rare
Smooth muscle actin neg to rare
S100 neg to rare
Factor XIIIa neg
CD31 neg
CD68 neg

 

Differential Diagnosis

Sclerotic Fibroma / Storiform Fibroma Sclerotic Lipoma
Prominently concentric lamellar collagen Collagen infrequently lamellar
Factor XIIIa and CD34 positive Factor XIIIa and CD34 negative to rare
May be associated with Cowden disease Not associated with Cowden disease

Fibrolipoma Sclerotic Lipoma
Focal fibrous tissue in a lipoma Focal fat in a predominantly fibrous lesion
Various locations Predominantly located on fingers

Spindle Cell Lipoma Sclerotic Lipoma
Ropy bundles of collagen Diffuse collagen
Usually has cellular areas Hypocellular
CD34 extensive positivity CD34 negative to rare

Desmoplastic Fibroblastoma Sclerotic Lipoma
Fat is not intrinsic to tumor Fat is intrinsic to lesion

Fibroma of Tendon Sheath Sclerotic Lipoma
Lacks intrinsic fat Fat intrinsic to lesion
Smooth muscle actin positive Smooth muscle actin negative to rare
Both are common on the fingers

Superficial Acral Fibromyxoma Sclerotic Lipoma
Noncircumscribed Circumscribed
CD34 positive CD34 negative to rare
Lacks intrinsic fat component Fat is integral to lesion
Both are common on the fingers

Clinical

Bibliography

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