Surgical Pathology Criteria

Pleomorphic Lipoma

Differential Diagnosis

Spindle Cell Lipoma vs. Pleomorphic Lipoma

Pleomorphic Lipoma vs Atypical Lipomatous Tumor

Pleomorphic Lipoma Fat Necrosis
At least scattered large eccentric nuclei Small central nuclei
No prominent foamy cell population Foamy cells frequently fill spaces of dead adipocytes
Ropy collagen No ropy collagen
Restricted to back of neck, upper back and shoulders Various locations

Pleomorphic Lipoma Pleomorphic Hyalinizing Angiectatic Tumor
No intracytoplasmic hemosiderin Intracytoplasmic hemosiderin
No aggregates of large vessels Aggregates of vessels with hyalinized walls and fibrin
Ropy collagen No ropy collagen
Restricted to back of neck, upper back and shoulders Various locations
Both are CD34 positive

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