Journal List > Korean J Cytopathol > v.19(2) > 1006529

Korean J Cytopathol. 2008 Sep;19(2):200-205. English.
Published online September 30, 2008.  https://doi.org/10.3338/kjc.2008.19.2.200
Copyright © 2008 The Korean Society for Cytopathology
Imprint Cytology of Hibernoma -A Case Report-
Joon Hyuk Choi, M.D., and Duk Seop Shin, M.D.1
Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea.
1Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.
Received July 17, 2008; Accepted September 04, 2008.

Abstract

Hibernoma is a rare, benign adipose tumor composed of brown fat cells with eosinophilic granular or multivacuolated cytoplasm. The cytologic features of hibernoma have been rarely reported and may mimic other polygonal cell neoplasms. We report the imprint cytologic features of a case of hibernoma in the left thigh of a 68-year-old woman. Microscopic examination showed large, round, or polygonal brown fat cells. The cells were arranged in fragments or clusters. The nuclei were uniformly round with finely granular chromatin. The cytoplasm was multivacuolated or univacuolated. The abundant eosinophilic granular cytoplasm was also present. No nuclear atypia were present. Immunohistochemical staining showed that cells were positive for S-100 protein.

Keywords: Hibernoma; Cytology

Figures


Fig. 1
Magnetic resonance imaging. Coronal T1-weighted image shows a well defined mass with intermediate signal intensity (arrow) in the left thigh.
Click for larger image


Fig. 2
Positron emission tomography / computed tomography (PET/CT). PET/CT shows a well circumscribed, hypermetabolic soft tissue mass (arrow) in the left thigh.
Click for larger image


Fig. 3
Cytologic findings. (A) Tumor shows large, round, polygonal cells in a cellular fragment (Papanicolaou stain). (B) The background shows granular eosinophilic materials (H&E). (C) The tumor cells have multivacuolated cytoplasm. The nuclei of these cells are small and round and slightly eccentrically located in the cytoplasm (H&E). (D) Some tumor cells are round or polygonal and have eosinophilic granular cytoplasm (H&E). (E) Univacuolated fat cells are present (Papanicolaou stain). (F) These tumor cells are positive for S-100 protein (Immuohistochemical stain).
Click for larger image


Fig. 4
Gross finding. Tumor shows a well circumscribed, yellow-tan soft cut surface.
Click for larger image


Fig. 5
Histologic finding. The tumor is composed of large polygonal cells with multivacuolated or eosinophilic granular cytoplasm and matured adipocytes (H&E).
Click for larger image

Tables


Table 1
Published cases of hibernomas in the Korean literature
Click for larger image

References
1. Weiss SW, Goldblum JR. In: Enzinger and Weiss's Soft Tissue Tumors. 5th ed. St. Louis: Mosby, Inc.; 2008. pp. 466-470.
2. Miettinen MM, Fanburg-Smith JC, Mandahl N. Hibernoma. In: Fletcher CDM, Unni KK, Mertens F, editors. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon: IARCPress; 2002. pp. 33-34.
3. Hashimoto CH, Cobb CJ. Cytodiagnosis of hibernoma: a case report. Diagn Cytopathol 1987;3:326–329.
4. Lemos MM, Kindblom LG, Meis-Kindblom JM, et al. Fine-needle aspiration characteristics of hibernoma. Cancer 2001;93:206–210.
5. Saqi A, Yu GH, Marshall MB. Fine-needle aspiration of hibernoma. Diagn Cytopathol 2003;29:44–45.
6. Akerman M, Rydholm A. Aspiration cytology of lipomatous tumors: a 10-year experience at an orthopedic oncology center. Diagn Cytopathol 1987;3:295–302.
7. Kapila K, Ghosal N, Gill SS, Verma K. Cytomorphology of lipomatous tumors of soft tissue. Acta Cytol 2003;47:555–562.
8. Kempson RL, Fletcher CDM, Evans HL, Hendrickson MR, Sibley RK. In: Tumors of the Soft Tissues. Bethesda: Armed Forces Institute of Pathology; 2001. pp. 195-197.
Atlas of Tumor Pathology. 3rd series Fascicle 30.
9. Furlong MA, Fanburg-Smith JC, Miettinen M. The morphologic spectrum of hibernoma: a clinicopathologic study of 170 cases. Am J Surg Pathol 2001;25:809–814.
10. Kim HN, Jee MK, Gang SJ, Kim BK, Kim SM. Hibernoma: a case report. Korean J Pathol 1988;22:353–355.
11. Ahn S, Lee SH, Lee S. A case of hibernoma. Korean J Dermatol 1991;29:100–103.
12. Kim HY, Kim HU, Ihm CW. A case of hibernoma arising in the scalp. Korean J Dermatol 1992;30:258–261.
13. Jeon YS, Chun CG, Jun YJ, Cho WH, Choi JB. Hibernoma of lower chest wall, left: one case report. Korean J Thorac Cardiovasc Surg 1997;30:467–470.
14. Lee TJ, Park IS, Kim MG, Cho KJ, Moon KH, Lim KY. Axillary hibernoma: MRI characteristics: a case report. J Korean Orthop Assoc 2004;39:335–338.
15. Kim CY, Choi DJ, Oh CW. A case of hibernoma. Korean J Dermatol 2005;43:983–985.
16. Ha JW, Kim HS, Park JO, Chung JY, Pyo JY, Moon ES. Hibernoma in psoas muscle: a case report. J Korean Soc Spine Surg 2006;13:306–310.
17. Kim KH, Hur J, Yoon CS. Hibernoma of the psoas muscle: a case report. J Korean Radiol Soc 2007;56:69–72.
18. Dardick I. Hibernoma: a possible model of brown fat histogenesis. Hum Pathol 1978;9:321–329.
19. Gaffney EF, Hargreaves HK, Semple E, Vellios F. Hibernoma: distinctive light and electron microscopic features and relationship to brown adipose tissue. Hum Pathol 1983;14:677–687.
20. Gisselsson D, Höglund M, Mertens F, Dal Cin P, Mandahl N. Hibernomas are characterized by homozygous deletions in the multiple endocrine neoplasia type I region. Metaphase fluorescence in situ hybridization reveals complex rearrangements not detected by conventional cytogenetics. Am J Pathol 1999;155:61–66.
21. Gisselsson D, Domanski HA, Höglund M, et al. Unique cytological features and chromosome aberrations in chondroid lipoma: a case report based on fine-needle aspiration cytology, histopathology, electron microscopy, chromosome banding, and molecular cytogenetics. Am J Surg Pathol 1999;23:1300–1304.
22. Sung WJ, Choi JH. Imprint cytology of granular cell tumor: a case report. Korean J Cytopathol 2007;18:170–174.
23. Layfield LJ. In: Cytopathology of bone and soft tissue tumors. New York: Oxford University Press, Inc.; 2002. pp. 78-79.
24. Pant I, Kaur G, Joshi SC, Khalid IA. Myxoid liposarcoma of the breast in a 25-year-old female as a diagnostic pitfall in fine needle aspiration cytology: report of a rare case. Diagn Cytopathol 2008;36:674–677.
25. McGregor DK, Krishnan B, Green L. Fine-needle aspiration of adult rhabdomyoma: a case report with review of the literature. Diagn Cytopathol 2003;28:92–95.