Diagnostic pitfalls in fine needle aspiration cytology of pleomorphic lipoma - A case report

BACKGROUND: Pleomorphic lipoma is an unusual pseudosarcomatous condition wi th characteristic morphology. Despite its pleomorphic appearance, it follow s a benign course and does Mot recur or metastasize if completely excised. CASE: A 66-year-old man presented with swelling in the back of the neck of approximately six months' duration. The focally cellular aspirate revealed round to oval, hyperchromatic cells, rare multinucleated cells and fragment s of mature adipose tissue. On initial evaluation, the smear pattern sugges ted a malignant neoplasm. However, upon review of the cytologic material al ong with histology, the characteristic pattern, including floret cells, was recognized. CONCLUSION: The rarity of pleomorphic lipoma and the atypical cellular feat ures of the aspirate can cause difficulty in diagnosing this entity. Awaren ess of this rave but not-uncommon entity, along with clinical correlation, is crucial in arriving at the correct diagnosis.