Penis and scrotum
Nonneoplastic lesions of scrotum
Sclerosing lipogranuloma

Authors: Antonio Cubilla, M.D., Alcides Chaux, M.D. (see Authors page)

Revised: 9 April 2018, last major update May 2010

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Sclerosing lipogranuloma

Cite this page: Cubilla, A., Chaux, A. Sclerosing lipogranuloma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/penscrotumsclerosinglipo.html. Accessed October 18th, 2018.
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

Images hosted on PathOut server:

Marked deformity of penis

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

Images hosted on PathOut server:

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

Images hosted on PathOut server:

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