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Presented by Dr. Argani and prepared by Austin McCuiston.
This is a 4 week old male who undergoes an omental biopsy
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1. Question
This is a 4 week old male who undergoes an omental biopsy.
Correct
Answer: Fat necrosis
Histologic Description: This tissue consists of atrophic fat associated with mesothelial cells, consistent with omental tissue. The fat demonstrates uniform myxoid change with prominent capillary vasculature, simulating the morphology of myxoid liposarcoma. The changes are microscopic throughout the specimen, affecting virtually every fat lobule, and no mass lesion was identified. These features support the diagnosis of fat necrosis. This child was extremely ill which fits the picture
Differential Diagnosis: Well differentiated liposarcoma occurs in adults and would feature atypical, hyperchromatic lipoblasts in fibrous septa. Lipoblastoma resembles the current lesion; however, there is typically a mass lesion present, and the more immature appearing fat is at the edge of the lobules of the lesion. Myxoid liposarcoma similarly makes a mass lesion and demonstrates greater cytologic atypia.
Incorrect
Answer: Fat necrosis
Histologic Description: This tissue consists of atrophic fat associated with mesothelial cells, consistent with omental tissue. The fat demonstrates uniform myxoid change with prominent capillary vasculature, simulating the morphology of myxoid liposarcoma. The changes are microscopic throughout the specimen, affecting virtually every fat lobule, and no mass lesion was identified. These features support the diagnosis of fat necrosis. This child was extremely ill which fits the picture
Differential Diagnosis: Well differentiated liposarcoma occurs in adults and would feature atypical, hyperchromatic lipoblasts in fibrous septa. Lipoblastoma resembles the current lesion; however, there is typically a mass lesion present, and the more immature appearing fat is at the edge of the lobules of the lesion. Myxoid liposarcoma similarly makes a mass lesion and demonstrates greater cytologic atypia.