유경성 지방섬유종의 임상 및 병리조직학적 관찰 - 표재성 피부지방종성 모반과의 비교 관찰 - = A Clinicopathological Study of the Pedunculated Lipofibromas - A comparison with Nevus Lipomatosus Cutaneous Superficialis -유경성 지방섬유종의 임상 및 병리조직학적 관찰 - 표재성 피부지방종성 모반과의 비교 관찰 -

다국어 초록 (Multilingual Abstract)

Background:Nevus lipomatosus cutaneous superficialis(NLCS) was originally classified into two clinical types:a multiple form and a solitary one. Mehregan et al proposed the term pedunculated lipofibroma for the solitary form of NLCS in view of its distinctive clinicopathological features. Objective:Pedunculated lipofibroma is a relatively rare benign connective tissue proliferation abnormality characterized by ectopic adipose tissue in the dermis. The purpose of this study was to investigate the differences in clinicopathological findings between pedunculated lipofibroma and NLCSs. Methods:we performed the comparative clinicopathological studies of pedunculated lipofibromas and NLCSs among 9,940 patients who had skin biopsies for hisitopathological diagnosis during a recent 20 yeat period. In addition, we reviewed the NLCS cases previously reported in Korea. Results:We found 12 cases(0.12%) of pedunculated lipofibromas which showed a female preponderance. The lesions usually appeared as large, solitary, slow-growing, pedunculated to dome-shaped, skin-colored nodules or masses showng predilection for the buttock and upper thigh. However, 33.3% of lesions were present on non-pelvic girdle areas such as the back, upper arm, scalp, axilla and anterior chest. Most of the patients had a solitary lesion except for two patients who had two lesions. Histopathologically, all of the lesions were characterized by the presence of a central fatty core of mature adipose tissue infiltration admixing with dense stromal collagen. Several appendageal structures, perivascular and periappendageal deposition of mucin, and perivascular infiltration of mast cells were present in all of the lesions. Otherwise obvious acanthosis or papillomatosis were not present in the epidermis. We found 4 cases(0.04%) of NLCSs and reviewed 9 reported cases of NLCSs, which did not show the sexual differences in incidence. The lisions usually appeared as skin-colored confluent nodules which formed the zosteriform or cerebriform plaques. The majority of lesions(92.3%) were present on the pelvic girdle area except for one case with shoulder lesions. Histopathologically, all of the lesions showed the mature adipose tissues, epidermal hyperkeratoses, acanthoses, follicular pluggings and well-developed pilo-sebaceous units. Conclusion:Because of the distinctive clinicopathological differences between the solitary and multiple forms of NLCS, we agree with Mehregan’s proposal of nominating this solitary lesion as pedunculated lipofibroma.(Korean J Dermatol 1997;35(5):854∼862)