Penis and scrotum
Nonneoplastic lesions of scrotum
Sclerosing lipogranuloma


Topic Completed: 1 May 2010

Revised: 14 February 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Sclerosing lipogranuloma
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Cite this page: Chaux A, Cubilla AL. Sclerosing lipogranuloma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumsclerosinglipo.html. Accessed March 22nd, 2019.
Definition / general
Epidemiology
  • Rare; most patients are young adults
Sites
  • Usually affects penis, scrotum, spermatic cord and perineum
Etiology
  • Usually due to injection or topical application of oil based substances (paraffin, silicone, oil or wax) for cosmetic or therapeutic use (Arch Pathol Lab Med 1977;101:321)
  • Foreign body reaction is response to degenerated or damaged fatty tissue or lipids (Med Mol Morphol 2007;40:108)
  • May also be due to trauma and cold weather
  • Idiopathic cases with peripheral eosinophilia
Clinical features
  • Localized painless or slightly tender, indurated plaque / mass
  • Up to several centimeters
Clinical images

AFIP images

Marked deformity of penis

Gross description
  • Firm, yellow to grayish white areas
  • Solid or solid and cystic
  • Often fragmented
Gross images

AFIP images

Replacement of entire scrotal wall by solid yellow-white tissue with interspersed cysts

Microscopic (histologic) description
  • Fat necrosis, histiocytes, giant cells with extensive fibrosis and hyalinization
  • Lipid vacuoles with marked variation in size
  • Cysts, if present, lack epithelial lining but may contain giant cells
  • Also T lymphocyte infiltrate (Pathol Int 2003;53:121)
Microscopic (histologic) images

AFIP images

Characteristic vacuoles,
sclerotic stroma and
occasional foreign body
giant cells

Numerous, variably sized vacuolated spaces

Oil Red O stain

Positive stains
Differential diagnosis
  • Adenomatoid tumor: epitheliod and spindle cells, cystic spaces lined by flat, cuboidal or low columnar cells, no fat necrosis and no giant cells
  • Lymphangioma: cystic spaces lined by endothelium; no fat necrosis, no giant cells
  • Sclerosing liposarcoma: irregular adipocytes of variable sizes, presence of lipoblasts and usually no giant cells
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