Jaeger Filipe, Capistrano Hermínia Marques, de Castro Wagner Henriques, Caldeira Patrícia Carlos, Vieira do Carmo Maria Auxiliadora, de Mesquita Ricardo Alves, Ferreira de Aguiar Maria Cássia
Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Department of Oral Pathology and Surgery, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil.
Am J Case Rep. 2015 Nov 30;16:844-8. doi: 10.12659/ajcr.895474.
Spindle cell lipoma (SCL) is an uncommon and histologically distinct variant of lipoma. It usually occurs as a solitary, subcutaneous, and well-circumscribed lesion in the posterior neck, shoulders, and back of older men. SCL of the oral cavity is rare. We present the clinical-pathologic features of the third case of SCL located on the hard palate and discuss the histological differential diagnosis with other fusiform neoplasms.
A 56-year-old man was evaluated for an asymptomatic swelling on the right side of the hard palate. The intraoral examination showed a 25×20 mm sessile and circumscribed tumor, underlying an apparently healthy mucosa of normal color. The lesion revealed a floating consistency during palpation. Excisional biopsy was carried out based on a clinical diagnosis of lipoma or a benign minor salivary gland tumor. The histopathology demonstrated a well-circumscribed but unencapsulated proliferation of bland spindle cells admixed with mature adipocytes in a collagenous/myxoid stroma. The spindle cells were uniform, exhibiting elongated nuclei and narrow cytoplasmic processes without atypia. They were positive to CD34 and negative to factor VIII, alpha-smooth muscle actin, S100, cytokeratin, and actin. Mitotic activity was low, as confirmed by Ki-67 immunostaining. No lipoblastic activity was found. The diagnosis of SCL was therefore established.
Oral spindle cell lipoma is a rare benign lipomatous tumor. The histologic picture shows a range of variations and the observation of morphological features is important to distinguish this lesion from other fusiform tumors. Immunohistochemistry should be helpful in this differentiation.
梭形细胞脂肪瘤（SCL）是一种罕见的、组织学上独特的脂肪瘤变体。它通常表现为老年男性后颈部、肩部和背部的孤立性、皮下且边界清晰的病变。口腔内的SCL罕见。我们报告了第三例位于硬腭的SCL的临床病理特征，并讨论其与其他梭形肿瘤的组织学鉴别诊断。
一名56岁男性因硬腭右侧无症状肿胀接受评估。口腔检查发现一个25×20毫米的无蒂且边界清晰的肿瘤，其下方黏膜外观健康，颜色正常。触诊时病变质地柔软。基于脂肪瘤或良性小涎腺肿瘤的临床诊断进行了切除活检。组织病理学显示在胶原性/黏液样基质中，有边界清晰但无包膜的温和梭形细胞增殖，并混有成熟脂肪细胞。梭形细胞形态一致，核呈细长形，胞质突起狭窄，无异型性。它们对CD34呈阳性，对因子VIII、α平滑肌肌动蛋白、S100、细胞角蛋白和肌动蛋白呈阴性。Ki-67免疫染色证实有丝分裂活性低。未发现脂肪母细胞活性。因此确诊为SCL。
口腔梭形细胞脂肪瘤是一种罕见的良性脂肪瘤性肿瘤。组织学表现存在一系列变异，观察形态特征对于将该病变与其他梭形肿瘤区分开来很重要。免疫组织化学有助于这种鉴别。
