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Angiolipoma
,
Case of Angio!ipoma
KoichiDemura and Terumi Hamamatsu
angiolipoma, lipoma telangiectaticum
angiolipoma
1)3)
primitive fat
(Well)3)
4)6Cm
Lipoma durum Lipoma fib-
rosumLipoma moUe
.
Lipoma myxomatodes
From the Department of Dermatology, Niigata Prefectural Shibata Hospital, Shibata; under the guid-
ance of Prof. Hiroshi Tanaka, Director of the Department of Dermatology, Niigata University School
of Medicine, Niigata.
From the Department of Dermatology (Director: Prof. Hiroshi Tanaka), Niigata UniversitySchool
of Medicine, Niigata
81
82
Lipoma petrificum, Lipoma ossi-
ficans
5).
6)7)8)
fibrolipoma, angiolipoma
Angiolipoma
Little"
Portwein navus , Naevolipo-
mata
Unna
lo)
tton11
Werlhof
Homstein'"
72
Werlhof,
.
't),Panniculus adiposus
Rast"'
.
sinus
sinus
sinus
capillaires dormantes intersinusoidau
. Rohr (1949)"'
Reticulo-endothelium
capillaires intersimisoidaux
Rutishauser1954
capillaires intercytaires
3720
.
Rast"'
capillaires intercytaires
Held-Santa""
.
ti-Held19Fibroli-
poma
Fibroipoma
83
, Howard-Helwig,
, Angiolipoma
Bowe1
. BowenAngiolipoma
Ja,de22
Lipomes teleangiectasiques multiples
Bowen
Held-Santa
vascular lipoma, angiolipoma, angiofibrolipo-
ma, hemangiolipoma, lipoma teleangiectaticum
:55
:40
84
35
U
48110498Sahli
5,500,62
301.
30
175nig;'(1l,
109nigd1.
:45, 2.5%,
5.0Kunkel16.2
, Gros
7.5gr/dl,
62.3%, a-7.0%,13.1%,
72
Fig. 1
Fig. 2
Fig. 3
.
?17.,1.65.
1 min, 2 mm. 12668iMillg.
Mantoux24
3720
Fig. 4
Fig. 51
Fig. 6
Fig. 7
f
S5
, (11)
-
72
angiolipoma,
lipoma teleangiectaticum
, angiolipoma
.
(160
)
ABSTRACT
Lipoma is tumor of fatty tissue composed mainly of normal fattysandusually
encapsulated by fibrous tissue which also divides the tumor into lobules or incomplete
fibrous septa penetrate the tumor from the connective tissue capsule. Blood vessels
are another component of lipoma, but capillariesin lipoma as well as normal fatty
tissue are often hardly noticeable.Thesecapillariesexistinsertedinfattycellsand
their walls usually are pressed together, at some time they may be dilated and engorged
with red blood cells.Angiolipoma is basically an encapsulated fatty tumor, but the
degree of vascularity is much greater than that of simple lipoma. In angiolipoma usually
capillaryproliferation apparent proceeds from the peripheral margin inward, and
angiomatous features are pronounced adjacent to the capsular margin, but also inside
the tumor capillaries which are dilated and engorged with red blood cells are easily
observed.Clinically the nodules of angiolipoma maybe interpreted as lipomas because
the clinicalappearance of the tumor is essentially similar to that of the simple lipoma
Recently interesting articles about the vascularity of fatty tissue or fatty tumor
are successively presented. Held et Santa (1960) reported an affection titled sclerose
lipomateuse multicentrique par thromboses veinulaires du tissu adipeux. in which
marked vascularity and thrombotic obliteration of venous capillarieswere demonstrated
histologically.These authors considered that the characteristic features of this affection
3720
might be causedfromanunknown thrombogerdc process and that theseischemic
pathological findings of fatty tissue might be recognized as not so rare if more careful!
examinations of biopsy specimens were performed. Howard and Helwig (1960) examined
1678 specimens of various diagnoses of lipoma, hemangiolipoma, benign mesenchymoma.
angiofibroma, lipoma teleangiectaticum and angiolipoma.0f tMsgroup288lesions
removed from patients fulfilledthe authors' criteria for the diagnosis of angiolipoma.
Considering these reports this affection is apparently not rare. However, no recent
mention of it has been made in the Japanese literature, and for this reason the following
example is reported.
87
Reportof Case
man. aged 55was firstseen in our clinicof Niigata University School Medicine,
on September,1960. Fifteen years ago, he noticed finger-apex-sized nodular subcutaneous
swelling without nysubjective symptoms on tleftside of his waist. In few years
similar subcutaneous tumors increased in number and developed on the neck, waist
buttock and extremities. physical examination well-developed man was presented
with small finger-sized to thumb-sized subcutaneous nodules and indurations scattered
on the extensor surfaces of extremities. the waist and the buttock. Some of these
tumors were movable against the overlying skin and others were immovable and were
feltas indurated plaques.The older ones appeared as firm, immovable infiltrations.
The overlying skin was normal and somewhat elevated in some lesions. He had been.
in good health and the review of his familiarhistorywasnon-contributory.Laboratory
findingswere as follows :Urinanalysis, blood count and liver functiontestswere
normal.Serum total protein 7,5 g/dl.albumin 62.3%, a-globulin 7.0%,-globulin13.1
y-globulin 17.6% and A/G rate 1.65.Serum cholesterol 175 mg/dl, blood pressure 126
68]ninHg.Histopathologicalfindings were as follows:Tumors were mainly composed of
fatty cells and surrounded by connective tissue capsules. Generally, fatty cells were
smaller in size than those of common lipoma and atrophic. Tumors showed chara-
cteristicmarked vascularity.Capillariesamong fatty cells were exaggerated and filled
with red blood cells. Angiomatous proliferation was marked at the periphery of tumors
where capillarieswere blockaded by red blood cellsand were demonstrated as a fused
mass in the lumen, staining homogeneously dark red or violet red by hematoxylin-eosin.
and the wall of these vessels was swollen. New growth of genousfibers and
proliferation of endthelial cells were also demonstrated in some areas. No necrotic and
inflammatory changes were observed in tumors. As to the overlying skin tissues, slight
hyperkeratosis was observed in the epidermis. A dense collagenous proliferation was
observedinthedermis, sebaceous andsweat glands were almost normal except slight
atrophy. In the deep dermis and subcutaneous fatty tissue blOod vessels were dilated
and fatty cellsshowed tendency of atrophy. no changes of necrosis or inflammatioa
were noticed.
88
1) Eller & EUer: Tumor of the Skin, Philadel-
phia, Lea & Febiger (1951), p. 68.
2) Gans, O. u. Steigleder, G.K.Histologie der
Hautkrankheiten, Bd. II, Berlin, Springer-
Verlag (1957), S.440.
3) Wells, H.G.:J. Amer. Med. 114, 2177
(1940)
4, 29,
5217.
5) Dietel, F.:JadassohnsHandbuch d. Haut
. hlechtskrht XII/2, Berlin, Springer
(1932), S. 196.
6) Wright, C.J.E.:J. Path. & Bact. , 60, 483
(1948)
7) Stout, A.P.:Ann. Surg 119, 86 (1944)
8) Allen, A.C.:The Skin, St. Louis, C.V. Mos-
by (1954), p. 938.
9) Little, GArch. f Dermat., 107 464
(1911).
10) Unna:11.
11) Gottron, H.A.:Zbl. Hautkrkh., 59 634
72
(1938).
12) Hornstein, O.:Arch. klin. exp. Derm, 204,
397 (1957).
13) Nordmann, M.:Zschr. exp. 48, 84
(1926).
14) Rast, J.-P.:Presse med., 64, 139 (1956).
15) Doaa, Ch. .:14.
16) Rohr, K.:14.
17) Rutishauser, E, Rouiller, Ch. et Veyrat, R.:
14.
18) Held, D. etSanta, R.D.:Dermatologica,
120, 145 (1960).
19) Rutishauser, E. et Held, .:-18).
20) Howard, C.W.R. & Helwig, E.B.:A.M.A.
Arch. Dermat 82, 924 (1960).
21) Bowen, J.T.:Am. J. Med. Sc., 144, 189
(1912).
22) Jausion et Grandclaude: Bull. Soc. Fr. Derm.
et Syph, 33, 29 (1926).
36
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