Endobronchial Lipoma
Key Facts
Terminology
Synonym: Lipomatous hamartoma
Definition: Benign mesenchymal neoplasm composed exclusively of mature adipose tissue
Clinical Issues
Cough
Shortness of breath
Obstructive pneumonia
Lipomas are more commonly seen as bronchial tumors
Macroscopic Features
Well circumscribed
Soft and yellowish
Polypoid tumor obstructing bronchial lumen
Variable size: 1-5 cm in diameter
Microscopic Pathology
Mature adipose tissue
Spindle cells
Myxoid changes
Absence of atypia or mitotic figures
Top Differential Diagnoses
Hamartoma
Usually has presence of cartilage
Usually has invaginations of the respiratory epithelium
Mixed tumor (pleomorphic adenoma)
Usually has epithelial component
May also have chondromyxoid areas
 Gross photograph shows an endobronchial lipoma  . Note the presence of a yellow tumor mass obstructing the main pulmonary airway. |
 Hematoxylin & eosin low-power view shows an endobronchial lipoma. Note the presence of extensive areas of mature adipose tissue  . |
TERMINOLOGY
Synonyms
Lipomatous hamartoma, fibrolipoma
Definitions
Benign mesenchymal neoplasm composed exclusively of mature adipose tissue
ETIOLOGY/PATHOGENESIS
Etiology
These tumors are of unknown etiology
Bronchial lipomas have been associated with obesity
CLINICAL ISSUES
Epidemiology
Incidence
Bronchial lipomas are unusual tumors
Age
Lipomas are more common in adults
Gender
No gender predilection has been observed
Site
Endobronchial location
Presentation
Cough
Shortness of breath
Obstructive pneumonia
Asymptomatic
Treatment
Surgical approaches
Lobectomy
Prognosis
Excellent
MACROSCOPIC FEATURES
General Features
Well circumscribed
Soft
Yellowish
Polypoid tumor obstructing bronchial lumen
Size
Variable size between 1-5 cm in diameter
MICROSCOPIC PATHOLOGY
Histologic Features
Mature adipose tissue
Spindle cells
Myxoid changes
Absence of atypia or mitotic figures
Predominant Pattern/Injury Type
Uniform
Predominant Cell/Compartment Type
Adipose
DIFFERENTIAL DIAGNOSIS
Hamartoma
Usually has presence of cartilage
Usually has invaginations of respiratory epithelium
Mixed Tumor (Pleomorphic Adenoma)
Usually has epithelial component
May also have chondromyxoid areas
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