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PubMed1982

Atypical lipoma.

In a previous clinico-pathologic and prognostic study of a Swedish national series of liposarcoma the designation atypical lipoma was suggested for a group of well-differentiated non-metastasizing liposarcomas characterized by only moderate nuclear atypia. In the present report, 21 new cases of atypical lipoma are described. The tumors were mainly composed of univacuolated fat cells without cellular or nuclear atypia, but also showed univacuolated fat cells with enlarged, moderately polymorphic, dark nuclei. In two of the tumors a few multivacuolated fat cells with scalloped nuclei were found. Small multinucleated cells with overlapping, peripherally arranged nuclei, reminiscent of so-called floret-like cells as in pleomorphic lipoma, could occasionally be seen. Areas of generally delicate linear or patchy fibrosis with atypical nuclei were a common finding. Two atypical lipomas were studied ultrastructurally. The ultrastructural findings suggest that the nuclear polymorphism is of a neoplastic nature rather than of a regressive changed. Nine atypical lipomas were located intramuscularly, two intermuscularly and ten subcutaneously. Five of the subcutaneous tumors and three of the inter-and intramuscular tumors recurred one or more times. Most of them, particularly the subcutaneous ones, had primarily been diagnosed as ordinary lipomas, but re-examination of the histological sections after one or more recurrence revealed overlooked nuclear atypia. Metastasis or dedifferentiation at recurrence was not seen in any case.

Adult↗
PubMedDate not supplied

Ultrasonographic features of canine lipomas.

The purpose of this study was to evaluate the ultrasonographic features of canine lipomas. A group of 94 dogs with a soft tissue mass was considered. All dogs were examined ultrasonographically and cyto/histologic examination was performed. Twenty-four dogs, whose mass was diagnosed as a lipoma, were selected. Fifty-five lipomas were present on the 24 dogs. Fifty-one lipomas were superficial and located subcutaneously. Four lipomas were deep and located in the paratesticular region. Ultrasonographically, lipomas appeared as oval, well-defined, encapsulated, striated masses.

Adipose Tissue↗
PubMed2004

Soft-tissue lipomas: accuracy of sonography in diagnosis with pathologic correlation.

PURPOSE: To retrospectively determine the accuracy of sonography in helping to distinguish soft-tissue lipomas from other soft-tissue masses by using histologic proof as the reference standard. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was waived. Thirty-nine patients who underwent sonographic evaluation of a soft-tissue mass followed by biopsy or resection were retrospectively evaluated. Two musculoskeletal radiologists (readers 1 and 2) reviewed the sonographic images, characterized the masses, and rated the level of confidence in the diagnosis of lipoma by using a five-point scale. A level of confidence was also rated for the prospective sonographic report, which was reviewed and designated as reader 3. Receiver operating characteristic (ROC) curves, including 95% confidence intervals, were generated, and the area under the ROC curve (A(z)) was calculated for each reader. Sensitivity, specificity, and accuracy for each reader were calculated by using a confidence rating of 4 or 5 as positive for lipoma. Weighted kappa analysis was also performed to assess for interobserver variability. RESULTS: Histologic examination yielded 25 lipomas and 14 nonlipomas. The echogenicity of lipomas ranged from hypoechoic to hyperechoic relative to muscle, although most were isoechoic or hyperechoic. A(z) values were 0.79 for reader 1, 0.56 for reader 2, and 0.77 for reader 3. There was no significant difference between the A(z) for each reader and for chance. Interobserver agreement was fair, with a kappa value of 0.35 among the three readers. Sensitivities were 52%, 40%, and 52%, and accuracies were 64%, 49%, and 64% for readers 1, 2, and 3, respectively. CONCLUSION: Sonography demonstrates low accuracy in the diagnosis of soft-tissue lipomas.

Adipose Tissue↗
PubMed2006

Lipoma of the deep lobe of the parotid gland: report of 3 cases.

Since lipomas are common soft-tissue neoplasms in other regions of the body, they are found only rarely in the parotid gland and are, therefore, often not considered in the initial differential diagnosis of parotid gland tumours. Even rarer are lipomas arising in the deep lobe of the parotid gland with only 6 cases presented in the literature. Lipomas originating in the parapharyngeal space are also extremely rare. When there is any suspicion, computed tomography and especially magnetic resonance imaging are of high diagnostic value. Fine-needle aspiration cytology seems not to contribute much to an accurate diagnosis. None of these preoperative examinations allows an absolute reliable distinction between a lipoma and a liposarcoma. The preferred treatment is complete surgical excision which will minimize the possibility of a recurrence and will also lead to a definitive diagnosis. We report 3 patients with a lipoma of the deep lobe of the parotid gland, extending into the parapharyngeal space, and discuss differential diagnosis and radiological features of lipomas in this rare location.

Female↗
PubMed1995

Spindle cell lipoma of the foot: a case report and literature review.

Lipomas are among the most commonly encountered soft tissue tumors in clinical practice, though they are rare in the foot. Although a presumptive diagnosis is typically made clinically, those tumors with atypical clinical features may require radiological consultation. Difficulty arises when radiographic features are not typical of lipoma. We present a fatty soft tissue tumor of the foot with nonadipose elements on magnetic resonance imaging evaluation. Differentiation of lipoma variants (e.g., spindle cell lipoma, atypical lipoma, pleomorphic lipoma, lipoblastoma, angiolipoma) from liposarcoma based on imaging features is not possible, necessitating surgical resection for definitive histological diagnosis.

Aged↗
PubMed2001

Atypical lipoma of the tongue.

We report an atypical lipoma arising in the tongue of a 43-year-old man who presented with an indolent dorsal lingual swelling. Atypical lipomas contain multivacoulated lipoblasts, which distinguishes them from benign lipomas. The superficial location in this case distinguishes this tumour from well-differentiated liposarcoma, which is biologically similar in lacking the propensity for metastasis. The superficial location of atypical lipoma allows a complete resection, which is often not possible for the deep-seated counterpart. Atypical lipoma and well-differentiated liposarcoma, if left in situ, may undergo transition to de-differentiated liposarcoma. Atypical lipoma should be completely excised with a cuff of normal tissue in order to prevent repeated local recurrence and the possibility of de-differentiation.

Adult↗
PubMedDate not supplied

[Intracranial lipomas].

INTRODUCTION: This paper reviews current literature about intracranial lipomas with emphasis on histogenesis, diagnosis and therapy. DEVELOPMENT: Intracranial lipoma is a congenital malformation. Epilepsy, mental dysfunctions and headache are the most common clinical manifestations, being a third of the asymptomatic cases; certain localizations cause specific symptomatology of the involved area. Associate anomalies are given in half of the lipomas, being the most frequent the agenesia of the corpus callosus. The diagnosis is not possible based on the clinical data, so it is necessary the practice of complementary exams in every suspected cases. The neuroimaging studies (TC or MRI) usually permit the diagnosis of this entity in an objective way and practically of certainty. It has been adduced a numberless histogenic theory on the lipomas, being accepted the lipoma like congenital malformation at the present time. The surgery is contraindicated, however still play a role in the management of some cases of hydrocephalus and bony affectation. The medical control of the epilepsy is forced. CONCLUSIONS: The development of the neuroimaging techniques and the biggest compression in the histogenesis have increased the knowledge that one had of the intracranial lipomas, modifying their presage and giving up the aggressive surgery of last times.

Brain↗
PubMed1975

[Diagnosis of intermuscular lipomas in children].

According to the data of literature intermuscular lipomas are observed in children, but rarely. The diagnosis of intermuscular lipomas presents certain difficulties since these tumors are frequently taken for sarcomas. Biopsy seems to be an important diagnostic method. From 1967 to 1972 the authors observed intermuscular lipomas in 3 children. One case report of a large intermuscular lipoma of the femur in a 2 year-old child is described. Surgery is considered to be the principal method of treatment for intermuscular lipomas. Recurrent intermuscular lipomas should be regarded as a warning against liposarcoma.

Child, Preschool↗
PubMed1992

[A case of asymptomatic endobronchial lipoma followed for 4 years].

Bronchoscopy was performed on a 68-year-old male patient with pulmonary tuberculosis, and revealed a yellow smooth polypoid tumor in the lumen of the left upper division bronchus. The histopathological diagnosis of the biopsy specimen was endobronchial lipoma. Since the patient did not have any symptoms due to the lipoma, we performed treatment for tuberculosis and continued careful observation of the tumor. During the subsequent 4 years, the patient developed no complications such as obstructive pneumonia, and the size of the tumor under bronchoscopic observation did not change. Endobronchial lipoma is a very rare benign tumor. Almost all reported cases have undergone operation or endoscopic surgery. This case is the first that was followed over 4 years without surgical procedure. The findings of follow-up bronchoscopic examination suggest that the growth rate of endobronchial lipoma is very slow. Furthermore, we reviewed 36 cases of endobronchial lipoma in the Japanese literature, including our case. Smoking seems to have a strong relation to the occurrence of the tumor. It is noteworthy that 6 cases had separate malignancies, but the direct relationship between endobronchial lipoma and such malignancies is unclear.

Aged↗
PubMed2003

Giant pericardial lipoma: unusual cause of intrathoracic mass.

INTRODUCTION: Pericardial lipomas are rare clinical findings. We describe a case of pericardial/epicardial lipoma seen recently at our hospital. CLINICAL PICTURE: A 68-year-old lady presented with a 1-year history of dull aching upper abdominal pain. A chest X-ray revealed a large mass lesion in the right hemithorax. Computed tomography (CT) scan of the chest defined the nature of the lesion. CT-guided fine needle aspiration cytology showed mature fat cells. TREATMENT: The large lipoma (19 x 10 x 4 cm, 1500 g) was completely excised along with a block of the parietal pericardium; through standard right posterolateral thoracotomy. OUTCOME: The patient had an uneventful postoperative recovery. She is currently asymptomatic and has no evidence of recurrence at 18 months follow-up. CONCLUSION: Lipomas in the thoracic cavity are rare and pericardial lipomas even rarer. These are best identified on imaging studies including a CT scan. Complete surgical excision of the lipoma is the only mode of treatment and adequate surgery the only way to prevent future recurrences.

Female↗
PubMedDate not supplied

Intestinal lipoma: a rare cause of lower gastrointestinal haemorrhage.

Lower gastrointestinal bleeding from submucosal lipomas of the intestine is very rare. We report our experience with 3-patients presenting with lower gastrointestinal haemorrhage who were detected to have no cause other than intestinal lipomas. In two of these patients, the lipoma was in the small intestine and presented with chronic blood loss or recurrent episodes of bleeding. The third patient presented with massive haematochyzia and had a number of lipomas in the cecum and right colon. The diagnosis was established by laparotomy and intraoperative enteroscopy in 2 cases, and by colonoscopy and laparotomy in the third. Surgical excision of the lipoma led to cure in all the patients. We conclude that when laparotomy and intraoperative enteroscopy fail to show any cause for bleeding other than an innocuous-looking lipoma, it should be excised. The literature has been reviewed.

Adult↗
PubMed2005

[Pleural lipoma: report of a case].

Although lipomas are the most common form of the benign neoplasm, occurrence within the thoracic cage is uncommon, and lipomas originating from the pleura are very rare. We report an unusual case of a 63-year-old male whose serial chest X-ray demonstrated an abnormal shadow of which size was increasing. A chest wall tumor was suspected based on the findings of computed tomography (CT) of the thorax. The tumor was resected by video-assisted thoracoscopic surgery and the patient remains well with no recurrence 4 years postoperatively. The resected tumor was a yellowish pleural mass and the pathological diagnosis was a benign lipoma. It is possible to make a diagnosis of lipoma preoperatively by CT and magnetic resonance imaging (MRI), however, the correct differential diagnosis of lipoma and liposarcoma is imperfect only by radiological findings necessitating surgical removal if possible. However, in view of the imperfect differentiation between lipoma and liposarcoma, surgical treatment should be considered.

Humans↗
PubMed1989

[Intracranial lipoma; MR imaging].

Reported here are five patients with intracranial lipoma. Three of these had pericallosal lipoma. One patient had a lipoma in the quadrigeminal cistern. The remaining one had a lipoma in the interpeduncular cistern. All of these tumors were clearly demonstrated and were homogeneously hyperintense on T1-weighted MR images. One patient with a pericallosal lipoma had also partial agenesis of the corpus callosum. However, all patients had no symptoms relating these tumors. It was concluded that MR imaging is useful for diagnosing intracranial lipomas and associating anomalies.

Adult↗
PubMed1986

[Lumbosacral lipoma: computed tomographic scan findings and surgical correction].

Display of the specific anatomic derangements by high-resolution computed tomographic (= CT) scan provides an important basis for planning corrective surgery of lumbosacral lipoma. In this paper, analysis of four infants and a child with lumbosacral lipoma revealed following discrepancy between the image by CT scan and operative finding. Most of lipoma showed a sharply outlined area of low density (approximately -100 H.U.) in the CT scan. Lipoma in the spinal cord parenchym represented intermingled fatty and neural tissue. There were also relatively high density areas in some cases and correspondingly, there were very fibrous lipomas, which could be identified by microscopic histological examination. Although there was a general correlation between the site of lumbosacral skin abnormality and underlying intraspinal lesion, some case does not match perfectly. In conclusion, a removal of the lumbosacral lipoma for the tethering effect always preferable to a total extirpation even though with technological advances in operative magnification and surgical instrumentation and a removal of the compressing lamina is necessary for adequate decompression.

Child↗
PubMed1984

External lipomas in three horses.

Lipomas involving the musculoskeletal system were seen in 3 horses. The lipomas were on the thorax of 2 horses and the stifle of the third horse. The thoracic lipomas were surgically removed. No recurrence has been noted by 8 months in either case. The lipoma on the stifle had invaded the surrounding tissue and the horse was euthanatized. Unlike mesenteric lipomas, which occur in older horses, these lipomas all occurred in horses less than 2 years of age.

Animals↗
PubMed1993

[An hourglass type intrathoracic lipoma--a case report of surgical treatment].

We report a rare case of hourglass type intrathoracic lipoma. Until now, there are 114 reported cases on intrathoracic lipoma in Japanese literature, among which 22 are hourglass type. The patient was a 43-year-old woman, who was found to have a pleural tumor on her chest X-ray examination for healthy check-up. Computed tomography showed that it had intra- and extrathoracic portion with almost the same density as the subcutaneous fat tissue. The tumor was excised along with pleura, periostia and intercostal muscle approximately 1 cm apart from it. It was dumbbell-shaped and weighed 30 grams. Microscopically it was found to be intramuscular lipoma. According to Fletcher, intramuscular lipoma was classified into two groups of infiltrative and non-infiltrative type. In their cases, infiltrative intramuscular lipomas recurred up to 19%, mainly secondary to incorrect resection. Our case corresponds to infiltrative type. We consider that intrathoracic lipoma, though benign, have to be resected radically with utmost care.

Adolescent↗
PubMed1997

Expression of HMGI-C and HMGI(Y) in ordinary lipoma and atypical lipomatous tumors: immunohistochemical reactivity correlates with karyotypic alterations.

The high mobility group proteins (HMGs) are a class of low molecular weight, nonhistone, nuclear proteins that bind DNA and function as transcription cofactors. This class includes the HMGI family members HMGI-C and HMGI(Y). Both are not significantly expressed in differentiated adult tissues, including fat, but their expression is induced in proliferating and transformed cells. Their involvement in the development of lipomatous tumors has been recently demonstrated for HMGI-C, which is encoded by a gene located at 12q15, the chromosomal segment often rearranged in ordinary lipomas. The same chromosomal segment is consistently amplified in the ring and giant marker chromosomes of atypical lipomatous tumors (ALTs), a term used to designate tumors previously labeled as well differentiated liposarcomas or atypical lipomas. The involvement of HMGI(Y) is strongly suspected as the gene coding for HMGI(Y) is located at 6p21, a chromosomal segment rearranged in a subset of ordinary lipomas. HMGI-C or HMGI(Y) protein expression was analyzed immunohistochemically in a group of 39 well differentiated adipose neoplasms (19 lipomas and 20 ALTs) of known karyotype using polyclonal antibodies raised against a recombinant protein (HMGI-C) and against a synthetic peptide (HMGI(Y)). The results of this study demonstrate that HMGI proteins are commonly expressed in well differentiated adipose neoplasms. Seventeen of twenty ALTS (85.0%), all of which had ring or giant marker chromosomes with amplification of 12q13-15, strongly expressed HMGI-C. HMGI-C expression was detected in 7 of 11 ordinary lipomas (63.6%) with alterations at 12q14-15 and in one case with an abnormal karyotype that included double minute chromosomes. HMGI-C immunoreactivity correlates with 12q13-15 chromosomal alterations (P = 0.001). HMGI(Y) reactivity was demonstrated in only two ordinary lipomas: one with 6p21 rearrangement and one with normal karyotype. No significant HMGI(Y) expression was found in the ALT group. The finding of aberrant expression of HMGI proteins in well differentiated adipose neoplasms in association with 12q13-15 and 6p21 chromosomal changes supports the proposed pathogenetic role of this group of proteins in the development of adipose tissue tumors.

Adult↗
PubMed1998

Intermittent intussusception caused by colonic lipoma.

Colonic lipomas are rare, usually small, and occur most often in the right colon, particularly in the cecum. They are most common in elderly women. Intermittent episodes of intussusception are not uncommon in patients with colonic lipoma, but they are usually caused by larger pedunculated lipomas. We report a 43-year-old woman with a large colonic submucosal lipoma that induced intermittent colocolic intussusception. The patient presented with symptoms of peptic ulcer, including intractable upper abdominal pain, which did not resolve with treatment. Abdominal sonography showed typical findings of intussusception caused by a lipoma, but the manifestations on barium enema and computed tomography mimicked a malignant colonic tumor. The patient's abdominal pain disappeared after right hemicolectomy and the tumor was demonstrated to be a lipoma. The postoperative course was uneventful; there was no evidence of recurrence at follow-up 6 months later. Physicians should be aware that surrounding organs should also be evaluated in cases of chronic peptic ulcer with intractable upper abdominal pain.

Adult↗