Imaging Studies

CT scanning is indicated in a suspected liposarcoma. CT scanning is useful for distinguishing between lipomas and liposarcomas.^[15]

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).^[16]

Procedures

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

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.^[17]

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

Treatment & Management

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Sawamura S, Kajihara I, Jinnin M, Honda Y, Ihn H. Cutaneous spindle cell adenolipoma on the nose: A rare variant of lipoma. J Dermatol. 2017 Jul. 44 (7):e156-e157. [QxMD MEDLINE Link].
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Kawaguchi M, Kato H, Tomita H, Hara A, Matsuo M. CT and MR imaging findings of solitary nevus lipomatosus cutaneous superficialis: radiological-pathological correlation. Skeletal Radiol. 2020 Jan. 49 (1):129-135. [QxMD MEDLINE Link].
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Kuwano Y, Ishizaki K, Watanabe R, Nanko H. Efficacy of diagnostic ultrasonography of lipomas, epidermal cysts, and ganglions. Arch Dermatol. 2009 Jul. 145(7):761-4. [QxMD MEDLINE Link].
Sachdeva MP, Goldblum JR, Rubin BP, Billings SD. Low-fat and fat-free pleomorphic lipomas: a diagnostic challenge. Am J Dermatopathol. 2009 Jul. 31(5):423-6. [QxMD MEDLINE Link].
Juhlin L. Long-standing pain relief of adiposis dolorosa (Dercum's disease) after intravenous infusion of lidocaine. J Am Acad Dermatol. 1986 Aug. 15(2 Pt 2):383-5. [QxMD MEDLINE Link].
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Gonciarz Z, Mazur W, Hartleb J, et al. Interferon alfa-2b induced long-term relief of pain in two patients with adiposis dolorosa and chronic hepatitis C. J Hepatol. 1997 Dec. 27(6):1141. [QxMD MEDLINE Link].
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Media Gallery

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Surgical excision of a 6-cm lipoma on the back of a 54-year-old man using the squeeze technique.

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Author

Marjon Vatanchi, MD Board Certified Dermatologist, Board Certified Micrographic Dermatologic Surgeon

Marjon Vatanchi, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Dermatologic Society of Greater New York, Medical Dermatology Society, National Psoriasis Foundation, New England Dermatological Society, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Vineet Mishra, MD, FAAD Director of Mohs Surgery and Dermatologic Surgery, Assistant Professor of Dermatology, University of Texas Health Science Center at San Antonio

Vineet Mishra, MD, FAAD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American College of Phlebology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Janet Fairley, MD Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine

Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Federation for Medical Research, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Robert A Moraru, MD Staff Physician, Department of Dermatology, St Luke's/Roosevelt Hospital Center, Columbia Presbyterian Medical Center

Robert A Moraru, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Cutaneous Lipomas Workup

Imaging Studies

Procedures

Histologic Findings

References

Tables

Contributor Information and Disclosures

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