Angiolipoma

Breast - nonmalignant
Benign tumors / changes
Angiolipoma

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 24 August 2015, last major update August 2015

Copyright: (c) 2002-2015, PathologyOutlines.com, Inc.

PubMed Search: Angiolipoma [title] breast

Table of Contents

Cite this page: Angiolipoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastangiolipoma.html. Accessed July 14th, 2017.

Definition / general

Nodule composed of mature adipocytes, thin walled vessels and fibrin thrombi (essentially a lipoma with prominent vascular features)

Terminology

Described by Bowen a century ago and established as a pathologic entity by Howard and Helwig in 1960 (Arch Dermatol 1960;82:924)

Sites

Usually subcutaneous nodules on extremities and trunks of young adults, rare in breast

When in breast, it develops in subcutaneous fat, just in front of the pectoral fascia muscle and not within the breast parenchyma itself

Etiology

Unknown

Clinical features

Usually no pain, unlike angiolipoma elsewhere

Rarely exceeds 2 cm diameter

Radiology images

Mammography / X-ray: no typical appearance, may appear as focal increased density or an ill-defined mass/nodule

Ultrasound: well circumscribed hyperechoic mass without posterior enhancement

Prognostic factors

Not known to undergo malignant transformation

Case reports

55 year old man (Int J Surg Pathol 2011;19:813)

70 year old woman with firm mass (Radiology 2003;227:773)

73 year old woman with cellular angiolipoma of breast (Breast J 2002;8:47)

75 year old woman with multiple bilateral angiolipomas of breast (Aust N Z J Surg 1982;52:614)

Cellular angiolipoma of breast (Mod Pathol 1993;6:497)

Treatment

Usually simple surgical excision is curative

Wide excision may be needed for infiltrative variant

Clinical images

Various images

Microscopic (histologic) description

Circumscribed mass composed of mature adipose tissue mixed with capillary sized interanastomosing vascular proliferation

Intraluminal fibrin thrombi are common

Periphery of the lesion has a tendency for higher vascular density

The World Health Organization (WHO) 2002 classification of tumors of soft tissue and bone subclassifies into low vascular density (low vascularity) and cellular (50% or more vascular tissue, 25-30% of lesions (Int J Surg Pathol 2011;19:35, Breast J 2002;8:182)

Microscopic (histologic) images