Fine-needle aspiration of a pleomorphic lipoma of the head and neck: a case report

Pleomorphic lipoma is a rare soft-tissue tumor, most commonly seen in the head and neck regions of middle-aged men. Fine-needle aspiration (FNA) of these lesions can present a diagnostic challenge. Its large, hyperchromatic cells and multinucleated forms (floret cells) can easily be mistaken for a malignancy. A patient with a round, well-circumscribed, painless, soft, subcutaneous posterior neck mass for 6 yr presented to our FNA clinic. Aspiration of the mass showed a hypocellular specimen with atypical large and floret cells with fragments of mature fibroadipose tissue in the background. Based on the clinical and cytomorphological findings, a diagnosis of pleomorphic lipoma was suggested, and it was confirmed on excision. This case highlights the need to be aware of unusual benign lesions that may arise in the head and neck region. Knowledge of these benign lesions will help in making the correct cytological diagnosis when these lesions are sampled by FNA.