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Soft Tissue Tumors
Subconjunctival herniated orbital fat
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Reviewer: David Lucas, M.D., University of Michigan Health Systems (January 2009)
Revised: 26 June 2009, last major update June 2009
Definition
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● Prolapse of subconjunctival intraconal orbital fat
● First described in pathology literature in 2007 (AJSP 2007;31:193)
● Not a WHO diagnosis
Clinical
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● Rarely causes an intraorbital mass lesion
● Mean age 66 years, 90% men
● Prolapse is usually into superotemporal quadrant or lateral canthus; often bilateral
● Does not recur
Case reports
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● 52 year old woman with inferonasal mass (Nippon Ganka Gakkai Zasshi 2008;112:1085)
Clinical images
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Prolapse of orbital fat
Micro description
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● Mature fat, fibrous septa without hyperchromatic cells
● Adipocytes with intranuclear vacuoles (Lochkern cells) and floret cells (multinucleated giant cells with wreath like pattern of normal nuclei)
● Variable histiocytes, lymphocytes, plasma cells and mast cells
Positive stains
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● Floret cells - CD34 and vimentin
● Lochkern cells - CD34, vimentin and S100
Differential diagnosis
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● Pleomorphic lipoma - different clinical presentation; aggregates of bland spindle cells, floret cells and wiry collagen
● Well differentiated liposarcoma - different clinical presentation; enlarged hyperchromatic cells within fibrous septae
End of Soft Tissue Tumors > Subconjunctival herniated orbital fat
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