Lipomatous Metaplasia after Severe and Chronic Cutaneous Inflammation

Eyerich, Kilian; Traidl‐Hoffmann, Claudia; Albert, Annette; Kerzl, R; Rombold, Stephanie; Darsow, Ulf; Eberlein, Bernadette; Jakob, Thilo; Ring, Johannes; Hein, Rüdiger

doi:10.1159/000123234

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…The patient had a solitary 7-mm red-colored and dome-shaped papule on her thigh several inflammatory skin diseases and the regression of malignant skin tumors. 13,14 In our case, a large number of inflammatory cells infiltrated around the tumor, which might have caused adipocytic metaplasia. Previous cases of CSM with adipocytic metaplasia also showed inflammatory cell infiltration around the tumor.…”

Section: Discussionmentioning

confidence: 61%

A case of cutaneous syncytial myoepithelioma with extensive adipocytic metaplasia: Usefulness of EWSR1‐PBX3 gene fusion analysis

et al. 2022

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Cutaneous syncytial myoepithelioma (CSM) is a recently recognized variant of myoepithelioma characterized by an intradermal syncytial proliferation of spindled, ovoid, and histiocytoid cells. Immunohistochemically, tumor cells usually show strong expression of S-100 protein and epithelial membrane antigen (EMA). Here we report a case of CSM in the thigh of a 51-year-old Japanese woman. Histopathological findings showed a sheetlike growth of ovoid cells and histiocytoid cells with an eosinophilic syncytial cytoplasm, and adipocytic metaplasia was widely observed in the tumor. Immunohistochemical staining revealed a diffuse, strong pattern for EMA, smooth muscle actin (SMA), and HHF35, and variable expression of S-100 protein and p63 in ovoid and histiocytoid cells without significant mitotic figures or pleomorphism. In addition, EWSR1-PBX3 gene fusion, which is characteristic of CSM, was observed in the tumor. Based on these findings, we diagnosed the patient as having CSM. Our case shows that CSM can exhibit extensive adipocytic metaplasia, which could make its histopathological diagnosis challenging.

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Section: Discussionmentioning

confidence: 61%

A case of cutaneous syncytial myoepithelioma with extensive adipocytic metaplasia: Usefulness of EWSR1‐PBX3 gene fusion analysis

et al. 2022

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“…Eyerich et al described lipomatous metaplasia of the superficial dermis that presented as coalescing, lucent red to yellow‐brownish nodules on the thighs and upper arms of a 69‐year‐old woman . The lesions were noticed 2 months after acute generalized exanthematous pustulosis and the patient also had a history of psoriasis.…”

mentioning

confidence: 99%

Lipomatous metaplasia of superficial dermis

Tidwell

Rosenberg

2015

J Cutan Pathol

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Lipomatous metaplasia is an uncommon phenomenon. After identifying the presence of a band of adipocytes in the superficial reticular dermis underlying two excisions for basal cell carcinoma, we prospectively reviewed all skin specimens accessioned in our laboratory over a 6-month period and identified eight additional cases. In each example there was a band of adipocytes in the upper dermis, at the level of solar elastosis that was widely separated from the subcutaneous fat by a normal appearing reticular dermis. The cells were positive for S100 and negative for CD163. No connection between the superficial band of adipocytes and the subcutaneous or periappendageal fat was seen. The alterations were flat in configuration without polypoid changes. Eyerich et al. reported lipomatous metaplasia in the dermis of a patient with acute generalized exanthematic pustulosis and psoriasis, and postulated this to be a postinflammatory phenomenon. Fatty metaplasia occurs within a variety of cutaneous neoplasms including nevi, adnexal tumors and peripheral nerve sheath tumors. However, superficial dermal fatty metaplasia beneath cutaneous neoplasms is a newly described phenomenon and we suspect this process represents fatty metaplasia within solar elastosis and that it may occur more frequently than recognized.

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“…Lipomatous metaplasia is characterized by the presence of mature fat cells in the dermis and may appear associated with both benign and malignant lesions and even with inflammatory ones. 5,10,11 Based on the proposed etiology of GVvD-AA 6 and the known fact that adipose-derived mesenchymal stem cells present in the adipose tissue surrounding blood vessels are able to differentiate not only into endothelial cells but also into mesenchymal cells such as adipocytes, 12 we could postulate that in our patient's second lesion, hypoxia favored not only the appearance of the vascular lesion but also the proliferation of the surrounding adipocytes. However, as this is only a single case and lipomatous metaplasia was observed only in one of the two lesions excised from our patient, this remains speculative and we cannot exclude coincidental appearance of GvHD-AA and a lipomatous lesions.…”

Section: Discussionmentioning

confidence: 86%

Graft‐versus‐host disease‐associated angiomatosis with striking lipomatous metaplasia

et al. 2021

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Sclerodermatous graft-versus-host disease (GvHD) is one of the many clinicopathological variants of chronic GvHD. One of the rarest forms of this variant is GvHDassociated angiomatosis (GvHD-AA). We describe the case of a 62-year-old male with sclerodermatous GvHD who presented, in consecutive years, two different lesions that showed characteristics of GvHD-AA. The first lesion fitted perfectly with the previously known features of this rare entity. However, the second lesion was more interesting, as the angiomatoid lesion was surrounded by newly appeared adipocytes, something not previously described. The appearance of this peculiar adipose tissue may be explained as related to an important dermal atrophy, as a concomitant appearance of a lipomatous nevus and GvHD-AA, or, finally, as mature adipose tissue related to a previous inflammatory process, that is, lipomatous metaplasia. Both lesions were diagnosed as GvHD-AA, and the second one was considered to be associated with dermal lipomatous metaplasia. We also considered whether hypoxia could be related to both lesions. In the present report, we review previously published cases of GvHD-AA and discuss the different hypotheses that could explain the appearance of metaplasia associated with the second lesion.

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Lipomatous Metaplasia after Severe and Chronic Cutaneous Inflammation

Cited by 11 publications

References 21 publications

A case of cutaneous syncytial myoepithelioma with extensive adipocytic metaplasia: Usefulness of EWSR1‐PBX3 gene fusion analysis

A case of cutaneous syncytial myoepithelioma with extensive adipocytic metaplasia: Usefulness of EWSR1‐PBX3 gene fusion analysis

Lipomatous metaplasia of superficial dermis

Graft‐versus‐host disease‐associated angiomatosis with striking lipomatous metaplasia

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