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Lipomas (fatty tumors) · Lipomas signs & symptoms · Lipomas diagnosis · Lipomas treatment · Lipomas related articles
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Diagnosing a lump in the skin is important because the lump could be
- an infection—either a fresh abscess or an old walled-off infection called a granuloma,
- a collection of fluid—cyst, seroma, hematoma, or
- a tumor—which is another word for cancer.
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If the lump is a tumor, there is a 20-30% probability it will be malignant in a dog, and a 50-65% probability it will be malignant in a cat. When a tumor is diagnosed as a lipoma, it is a great relief, because these are not malignant. About 10% of all dog skin tumors are lipomas. Lipomas rarely occur in cats.
Veterinarians diagnose lipomas by
- feel (palpation),
- needle biopsy, and
- surgical biopsy or surgical excision.
Diagnosing fatty tumors: by feel (palpation)
Diagnosing a lipoma by feel is an inexact science. Normally, a lipoma feels smooth and slides away from underlying tissues, and malignant tumors adhere strongly to underlying muscle and bone. Unfortunately, using palpation as the sole method of diagnosing a mass is unwise. All masses should be definitively diagnosed because the sooner they are dealt with properly, the healthier your pet will be.
Diagnosing fatty tumors: by needle biopsy
A needle biopsy uses a needle and syringe to pull cells from the mass. The cells are blown from the needle onto a slide, stained, and examined under a microscope.
If the tissue on the slide is from a lipoma it will contain fat cells (lipocytes) with an enormous storage area (vacuole) filled with fat. The storage of fat takes up so much room that the cell’s nucleus is pushed over to the side. With a lipoma, no infection-fighting white blood cells are found on the slide—unlike the situation with an abscess or granuloma where white blood cells predominate. With a lipoma, the nuclei of the fat cells will be inactive—unlike the situation with a malignant tumor, which has active nuclear material.
While most veterinarians can make a preliminary diagnosis from a needle biopsy within a few minutes in the office, it is wise to have a pathologist review all slides. It is also wise to have every lump on your pet biopsied. If every lump is not assessed, it’s easy to develop a false sense of security. A false sense of security is especially common when the lumps are small, but small does not mean innocent.
Although needle biopsies distinguish lipomas from infections and from malignant cancers, they cannot distinguish between a lipoma and an infiltrative lipoma. This distinction requires a surgical biopsy.
Diagnosing fatty tumors: by surgical biopsy or surgical excision
A surgical biopsy removes a small, but representative sample of tissue, increasing the likelihood the diagnosis will be accurate. A surgical excision removes the entire tissue. Excisions of lipomas are generally easy because these tumors slide easily from the skin like a walnut from its shell. Infiltrative lipomas adhere to underlying tissue and cannot be completely excised.
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Material obtained through surgical biopsy or excision is divided into sections and stored in a preservative such as formaldehyde. The specimen is prepared, usually by freezing, so that it can be sliced into sections that are only a few cell layers thick. Using an electron microscope, a pathologist identifies the type of cells (fat, muscle, bone, skin, etc.) and their nuclear characteristics.
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The articles here were answered by a variety of pharmacists and veterinarians
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