![]() It is important to differentiate SCL from liposarcoma. Pleomorphic lipoma which is considered a highly pleomorphic variant was first described by Shmookler and Enzinger, as both of these have similar cytogenetics they are considered as a single entity 5. The spindle cells are CD34+ve and are S100-ve 4. Bundles of dense ropey collagen are present between the spindle cells. The amount of adult fat is variable and lipoblasts are generally not seen 2. The spindle cells have scant cytoplasm, elongated nuclei and are arranged in short parallel arrays. The matrix is composed of varying amounts of mucoid material and collagen. Histologically SCL consists of a mixture of bland spindle cell and mature adipocytes. T2 weighted MRI with fat suppression reveals a hypointense lipomatous component and a hyperintense spindle cell component which shows enhancement on contrast 3. On T1 weighted MRI the lesion is isointense to the subcutaneous fat. The variation in the ratio of fat and spindle cell causes the wide spectrum of imaging features. The radiological appearance is not pathognomic. Most common locations involve the posterior neck, shoulder and back however in our case the anterior triangle of the neck were involved. The condition predominantly involves the elderly males. DISCUSSIONĮnzinger and Harvey first reported on SCL in 1975 2. One year post operatively there is no evidence of a recurrence. On immunohistochemistry CD 34 antigen was positive and a diagnosis of spindle cell lipoma was made. The background showed mucoid matrix mixed with ropey collagen fibre bundles. The cells were arranged in short parallel bundles. On histopathological examination the tumor was composed predominantly of spindle cells which were uniform with an elongated nucleus with inconspicuous nucleloli. The mass was subcutaneous well defined and encapsulated. Patient underwent surgical excision of the mass. Post contrast showed a heterogenous enhancement. The lesion was extending anterior to the sternocleidomastoid muscle displacing the platysma. On computed tomography scan a 3.2x4.2 cm sized soft tissue density was seen in close proximity to the superficial lobe of the left parotid with tiny hypodensities of fat attenuation in the periphery. ENT examination and investigations were unremarkable.įine needle aspiration cytology showed loose arrangement of spindle cells in the myxoid matrix, suggestive of a soft tissue lesion. A 4x4 cm swelling was present in the anterior triangle of the neck which was firm and mobile. CASE REPORTĪ 48 year old male reported with a history of a left sided neck swelling since 2 years which was progressively increasing in size. The diagnosis of SCL is a histological one and careful study is required to differentiate it from the liposarcoma. Spindle cell lipoma (SCL) is a distinct entity accounting for about 1.5% of all lipomas 1. Solitary lipomas are the most common soft tissue tumor.
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