Track

Case Reports

Abstract

Spindle cell lipoma, a rare and distinct histological variant of lipoma, composed of bland spindle cells intermixed with mature adipose tissue. We describe a case of spindle cell lipoma with unusual histopathologic presentation, namely the presence of Verocay bodies resembling schwannoma. The case is a 48-year-old male who presented with a growing, nontender soft subcutaneous tumor approximately 3 cm with a firm nodular component approximately 1 cm in size on his posterolateral neck. An excisional biopsy was processed, and the sections revealed a relatively well-circumscribed nodular proliferation of predominantly spindled cells with nuclear palisades surrounding an acellular zone resembling Verocay body, which are commonly seen in schwannoma. However, on immunohistochemical study, the spindle cells were negative for S100 which only highlighted some scattered adipocytes. Additional sections revealed more associated adipocytes at the periphery of the lesion. The spindle cells are positive for CD34. A diagnosis of spindle cell lipoma was made. However, CD34 is not specific for spindle cell lipomas. The differential diagnoses will be discussed. This case emphasizes that the features of Verocay body- can also be seen in spindle cell lipoma and highlights the importance of histological examination with immunohistochemistry to confirm a relatively rare entity such as spindle cell lipoma.