What is Angiolipoma?
The condition is also known as vascular lipoma, haemangiolipoma and fibromyolipomas. It is a soft tissue nodule present subcutaneously, having a vascular structure (comprising blood vessels) with characteristics resembling that of lipoma. This swelling contains fibrin thrombi, thin walled blood vessels and mature adipocytes. They can be of two types: infiltrating and non-infiltrating. Earlier, the terminology infiltrating (intramuscular) angiolipoma, but this terminology is no longer acceptable, as it represents a lesion which is entirely different. It is a large intramuscular vessel haemangioma in which muscle mass gets replaced by fat tissue.
Exact reason of occurrence of this tumor is not known. However, it may have a genetic factor involved. In rare cases, some minor injuries are known to develop angiolipoma later at the site.
Symptoms of Angioploma
This condition is mainly characterized by the appearance of small nodules under the skin. It is not a malignant lesion and is mainly composed of blood vessels and adipose tissue only. They may be soft to touch in their initial stages, and are harder later. When they first appear, they are slightly mobile with digital pressure. They are also painful. They are generally small in size but gradually grow in size and can reach unto 6 cms. The presence of a single lesion is unusual in any individual. Generally, two or more lesions are seen. They appear as bumps over the skin surface, underlying skin.
It is generally seen in young adults or shortly after puberty. It is rarely seen in older adults and children. It has a 5% familial tendency of occurrence.
It is more commonly seen in the extremities and soft tissues of the trunk and neck. It is less commonly seen in hands, legs, face and head. Frequently, multiple lesions can be present, ranging from 2-4 nodules. Occasionally many nodules can be present.
The nodule can be painful and it is difficult to treat this condition if multiple nodules are present. Rarely, recurrent lesions can be seen.
Thick walled blood vessels and capillaries with pericytes, mainly concentrated at the periphery of the vessel. Mature adipose tissue cells are seen. Thrombi composed of hyaline or fibrin is one of the most important diagnostic features. The tumors are encapsulated with septations in between them. As the lesion gets older, fibrosis is seen. Mast cells are also present.
The lesion shows a mixture of fatty tissues and soft tissue components. It also shows a prominent vascular supply.
It is a subcutaneous mass, with a well circumscribed margin. It is a skin colour lesion which looks like lipoma. It is rarely larger than 2 cm in size. It has numerous mature adipose cells with many blood vessels. The vessels are manly capillaries. They can show accentuation in the subscapular area.
The lesion resembles any other lipoma clinically, but can be distinguished from other lipomas by biopsy. The distinguishing features of angiolipoma helps in establishing the diagnosis. Additional investigations inclu
de Retrograde ileoscopy and CT scan.
Kaposi’s sarcoma is a similar lesion, but differs from angiolipoma in some features like: Kaposi’s sarcoma shows patches, plaques or nodules. It is generally not well circumscribed and sis associated with HIV. It also has slits which show red blood cell extravasation.
Spindle cell haemangioendothelioma
This is a similar lesion, but has a poorly circumscribed margin and has epithelioid cells and biphasic spindle cells.this lesion also has cavernous vessels and is not associated with any other atypical angiolipomas.
This lesion has many thick walled vessels. The fat component is infrequent but can be rarely present. Fibrin thrombi are not seen in this lesion.
This lesion has myoid component and has large vessels with thicker vessel walls.
The lesions of this condition are usually harmless and painless and do not require any specific treatment. But if the lesion is painful and causes any hindrance in motion of any part, it needs specific medical treatment. If such a condition occurs, one can opt for removal of the tumour by liposuction or surgical removal. Most people opt for surgical treatment just because the tumour causes disfigurement in some part of their body. Liposuction is only helpful in cases where the tumor is soft. But even then, the tumor reappears at the site.
Angiolipoma surgery is a better option to avoid the recurrence of the lesion and requires complete and careful removal of the lesion. Not even a lining of the capsule should remain after surgical removal, or it can cause recurrence of the lesion. Surgical removal also leads to scarring.
Angiolipoma is a condition which is benign and does not cause any harm. It needs not be corrected. This condition does not have any preventive measures as well, as the exact cause of the occurrence is not known. The condition is never malignant and does not possess any life threatening complication.
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