Pathology interpritation please?!

[marilynluver]

ORIGINAL DIAGNOSIS:

SKIN AND SUBCUTANEOUS TISSUE, LEFT UPPER BACK, PUNCH BIOPSY:
  - ADIPOSE WITH CYTOLOGIC ATYPIA.
  - SEE COMMENT.

COMMENT:
Sections show unremarkable skin and a fragment of adipose where a
  percentage of the cells show nuclear enlargement and pleomorphism.  This
  case will be sent to the Joint Pathology Center for consultation.

AMENDMENTS:

CHANGE DIAGNOSIS

JPC Consult
SPECIMEN:
  4mm punch, left upper back

CLINICAL DIAGNOSIS AND HISTORY:
  35 year old female with a slowly enlarging 6cm soft, mobile, subcutaneous
  nodule presumed to be a lipoma. After injecting with lidocaine with
  epinephrine, lesions becomes firm and fixed. Ddx include lipoma vs
  angiolipoleiomyoma vs liposarcoma vs other soft tissue tumor. Double punch
  performed.

PRE-OPERATIVE DIAGNOSIS:
  SAA

POST-OPERATIVE DIAGNOSIS:
  Operative Findings: SAA
  Post-operative Diagnosis: SAA

GROSS DESCRIPTION:
  
\"4 mm Punch Left Upper Back\". Received in formalin is a skin punch biopsy
  4 mm in diameter and 0.5 cm in depth. Also receveid in the cup are 3
  fragments of yellow adipose tissue in aggregate 0.4 x 0.4 x 0.3 cm. TE
  multiple in 1.

FINAL DIAGNOSIS:
  CONSULTATION RESULTS RECEIVED FROM THE JOINT PATHOLOGY CENTER ON
  14 NOVEBER 2018):

SKIN AND SOFT TISSUE, LEFT UPPER BACK: LIPOMATOUS TUMOR.

Received for consultation on are 1 slide and 1 block. Additional
  sections are prepared from the tissue block.

  The specimen consists of a punch biopsy of essentially unremarkable skin,
  as well as fragments of adipose tissue. The adipose has scattered atypical
  cells with nuclear enlargement and hyperchromasia. Occasional degenerating
  adipocytes are seen, with associated lipophages. Some multi-vacuolated
  cells, reminiscent of lipoblasts, are also present. An immunohistochemical
  stain for p53 decorates many of the more atypical nuclei. Control tissue
  shows appropriate reactivity.

A dysplastic lipoma is favored. Complete excision of this lesion is
  advised to prevent recurrence.

This case was reviewed in consultation by the Division of Soft Tissue
  Pathology.

Additional testing for MDM2 by fluorescence in-situ hybridization is
  currently pending to help exclude an atypical lipomatous tumor. These
  results will be addended to this report up on receipt.