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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