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Table of Contents
Definition / general | Essential features | Epidemiology | Sites | Clinical features | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosis | Board review question #1 | Board review answer #1Cite this page: Lipoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorlipoma.html. Accessed July 14th, 2017.
Definition / general
- Benign colonic neoplasm composed of mature adipose tissue
Essential features
- Most common submucosal mesenchymal lesion of colon
- Typically small and benign, but can cause symptoms if large
Epidemiology
- Incidence may be as high as 4.4% but is more likely less than 1% (Gastroenterol Hepatol (N Y) 2011;7:490)
Sites
- Usually submucosal in right colon
Clinical features
- More common in elderly patients
- Larger lesions can cause symptoms, such as abdominal pain and intussusception (Am Surg 2006;72:83)
- Typically solitary, but rare patients may have multiple or diffuse lesions (Histopathology 2001;38:81)
- Patients may have concurrent malignancy (J Surg Oncol 1991;47:170)
Case reports
- 83 year old woman with ascending colon lipoma (World J Gastroenterol 2005;11:3167)
Treatment
- Removal by colonoscopy or surgery (Eur J Surg 1991;157:51)
Gross description
- Soft, yellow cut surface
- Size can vary; large lesions may have overlying ulceration
Gross images
Images hosted on other servers:
Large pedunculated submucosal tumor
Cut section of tumor
Microscopic (histologic) description
- Benign, well circumscibed (but not encapsulated) adipose tissue, usually in the submucosa
- Overlying mucosa usually normal but may show an adenoma or a serrated polyp (World J Clin Cases 2013;1:124)
- May have overlying mucosal ulceration, atypical stromal cells and florid vascular proliferation due to repeated intussusception (Pathol Int 2005;55:160)
Microscopic (histologic) images
Images hosted on PathOut server, courtesy of Raul S. Gonzalez, M.D:
Large lipoma with overlying ulceration
Images hosted on other servers:
Lipoma with overlying sessile serrated adenoma
Differential diagnosis
- Lipomatous hypertrophy of ileocecal valve: also benign; not well circumscribed
Board review question #1
Benign fatty lesions of the colon usually arise in what layer of the wall?
A. Lamina propria
B. Muscularis mucosae
C. Muscularis propria
D. Submucosa
E. Subserosa
A. Lamina propria
B. Muscularis mucosae
C. Muscularis propria
D. Submucosa
E. Subserosa
Board review answer #1
D. Submucosa
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