PMC9150221_01
Axial image of the CT scan demonstrated a fat-containing lesion with soft tissue component and calcification. Involvement of the right common iliac vessels is noted.
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Abdomen and pelvic computed tomography (CT) scan showed a solid fat containing lesion with soft tissue density component and calcifications measuring about 80*72*45 mm in RLQ (Figure 1).
A- Axial T1W image of the abdomen showed a fat-containing mass (a) with partial encasement of the right common iliac artery (b) and invasion to the right common iliac vein (c). B- Axial T2W image of the abdomen showed a fat-containing mass (a) with partial encasement of the right common iliac artery (b) and invasion to the right common iliac vein (c). C- Enhancement of the soft tissue component of the lesion is seen with involvement of common iliac vessels.
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It was located adjacent to the right common iliac vessels, causing obliteration of the common iliac vein and encasement of the iliac artery (Figure 2).
A- Microscopic section shows clusters of thin-walled angiectatic vessels admixed with the adipose tissue and pleomorphic spindle cells (Hematoxylin and Eosin, 40x). B- Blood vessels with glomeruloid and papillary endothelial proliferation (Hematoxylin and Eosin, 200x). C- Pleomorphic tumoral cells with intracytoplasmic vacuoles (arrow head) and microthrombi (arrow) (Hematoxylin and Eosin, 400x). D-Hemosiderin pigment (Hematoxylin and Eosin, 400x). E- Calcification (Hematoxylin and Eosin, 400x). F-Ossification (Hematoxylin and Eosin, 100x). G-Mast cell infiltration (Hematoxylin and Eosin, 400x). H-Immunohistochemical stain for CD34 (200x).
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Microscopic examination showed a mixture of thin-walled ectatic blood vessels, spindle and pleomorphic tumoral cells, and lipomatous tissue with hyalinized collagenous areas (Figure 3(a)). Most blood vessels showed glomeruloid and papillary endothelial proliferation (Figure 3(b)). The intervening tumoral cells were spindle-shaped with marked pleomorphism; some of them had hemosiderin pigments with intracytoplasmic inclusions and micro-thrombi formation (Figures 3(c)-(d)). Small foci of ossification and calcification were seen (Figures 3(e)-(f)). Mast cells were present (Figure 3(g)). An immunohistochemical study was performed with positive CD34 in the tumoral cells (Figure3(h)).