A rare case of lipoleiomyoma of the vulva: Cytological and immunohistopathological study
A 38-year-old female, gravida 2 and para 2, presented to gynecology outpatient department with a left sided mass in the vulvar region. It was noticed one year back, which was small initially and gradually increased to the present size. Local examination showed 3 × 3 cm, nontender, well defined, soft to firm swelling in the labium majus. Overlying skin was unremarkable. Systemic examination findings were noncontributory. Fine needle aspiration cytology (FNAC) was advised.\nFNAC revealed moderately cellular smears composed of tissue fragments of cells with indistinct cell margins, moderate amount of eosinophilic cytoplasm and spindly nuclei of varying size. Few adipocytes were seen entrapped within the spindle cell fragments []. Background was hemorrhagic. Cytological report of benign spindle cell lesion with differential diagnosis of spindle cell lipoma and leiomyoma was offered. The complete excision of the lesion was advised for histopathological confirmation.\nOn gross examination, the tumor was ill circumscribed, partly encapsulated, soft to firm measuring 6 × 2.5 × 2 cm. On cut section, the tumor appeared whitish with yellowish and few tiny hemorrhagic areas [].\nOn microscopic examination, an ill circumscribed tumor mass composed of spindle cells arranged in interlacing fascicles and whorls, regularly interspersed with single and at places collections of mature adipocytes was observed. The spindle cells showed bland oval nuclei and moderate amount of eosinophilic cytoplasm []. No areas of necrosis and abnormal mitosis were noted. Based on histomorphologic appearance, differential diagnosis of lipoleiomyoma and neurofibroma with lipomatous differentiation was considered and representative sections were subjected for immunohistochemical studies.