Cutaneous Lipomas Workup

Updated: Aug 23, 2018
  • Author: Marjon Vatanchi, MD; Chief Editor: William D James, MD  more...
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Workup

Imaging Studies

CT scanning is indicated in a suspected liposarcoma. CT scanning is useful for distinguishing between lipomas and liposarcomas. [14]

Ultrasonography can be a useful modality for the diagnosis of lipomas. Compared with palpation, diagnostic accuracy rates were 88.1% with ultrasonography versus 54.8% with palpation alone (P< .01). [15]

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Procedures

Fine-needle aspiration or biopsy is indicated when the diagnosis of liposarcoma is suspected.

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Histologic Findings

Lipomas histologically resemble normal fat. When completely excised, a thin fibrous capsule surrounding the aggregate of adipocytes may be seen. Without a clinical or gross description, it can be impossible to distinguish between tumor cells and mature adipocytes.

One report describes the diagnostic challenge when encountering low-fat or fat-free pleomorphic lipomas. The authors suggested that identifying the classic nonlipogenic components and considering the clinical context are essential to ensuring diagnostic accuracy in pleomorphic lipomas. [16]

Lipomas differ biochemically from normal mature fat. Lipomas have increased levels of lipoprotein lipase.

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