Korean J Dermatol.  2024 Aug;62(7):375-381.

Relevance between Tenderness and Intra-Tumoral Platelet Aggregation in Angiolipoma and Lipoma Using CD61 Immunohistochemistry

• Kim JH
• Yoon H
• Lee SJ
• Kim MS

Abstract

Background
Angiolipoma is a disorder characterized by the development of distinct, encapsulated subcutaneous tumors. Unlike lipoma, angiolipoma is distinctively accompanied by tenderness, which does not respond to general painkillers. Additionally, the reason for the pain has not been elucidated yet.
Objective
This study aims to investigate platelet aggregation as the potential cause of tenderness in angiolipoma.
Methods
Twenty-three patients diagnosed with angiolipoma and lipoma were enrolled. Platelet aggregation was visualized by CD61 immunohistochemical staining. The area of platelet aggregation and vessel lumen in a high power field were measured with the QuPath software. The ratio between the area of platelet aggregation and vessel lumen (p/v ratio) was calculated from the captured images.
Results
Eleven of 46 patients complained of tenderness (9/23 angiolipoma [39.1%], 2/23 lipoma [8.7%]). Angiolipoma demonstrated a higher p/v ratio than that observed in lipoma (0.27 vs. 0.09, p＜0.001). Furthermore, the mean p/v ratio was high in patients with tenderness (0.44 vs. 0.09, p＜0.01). Patients were divided into three groups according to the aggregation pattern, highly clustered, mixed, and particulated. Nine patients with angiolipoma presented a highly clustered pattern, meanwhile, only three patients with lipoma exhibited a highly clustered pattern. Moreover, the number of patients with tenderness was significant in the highly clustered group (63.6%). Additionally, among the highly clustered group, the mean p/v ratio was higher in patients with tenderness (0.52 vs. 0.24, p＜0.01).
Conclusion
As clustered platelet aggregation with a high p/v ratio demonstrated relevance to tenderness, medications inhibiting platelet aggregation could mitigate tenderness in patients with angiolipoma.

Keyword

Adiposis dolorosa; Angiolipoma; Platelet aggregation