HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Murphey, M. D. Articles by Kransdorf, M. J. Search for Related Content PubMed PubMed Citation Articles by Murphey, M. D. Articles by Kransdorf, M. J. Related Collections Musculoskeletal Radiology

From the Archives of the AFIP

Benign Musculoskeletal Lipomatous Lesions¹

¹ From the Departments of Radiologic Pathology (M.D.M., J.F.C., T.L.P.) and Orthopedic Pathology (F.H.G.), Armed Forces Institute of Pathology, 6825 16th St NW, Bldg 54, Rm M-133A, Washington, DC 20306; Department of Radiology, Medical University of South Carolina, Charleston (T.L.P.); Departments of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (M.D.M., D.J.F.); Department of Radiology, University of Maryland School of Medicine, Baltimore (M.D.M.); Department of Radiology, National Naval Medical Center, Bethesda, Md (D.J.F.); and Department of Radiology, Mayo Clinic, Jacksonville, Fla (M.J.K.). Received June 1, 2004; revision requested June 7 and received June 24; accepted June 24. All authors have no financial relationships to disclose. Address correspondence to M.D.M. (e-mail: murphey@afip.osd.mil).

Benign lipomatous lesions involving soft tissue are common musculoskeletal masses that are classified into nine distinct diagnoses: lipoma, lipomatosis, lipomatosis of nerve, lipoblastoma or lipoblastomatosis, angiolipoma, myolipoma of soft tissue, chondroid lipoma, spindle cell lipoma and pleomorphic lipoma, and hibernoma. Soft-tissue lipoma accounts for almost 50% of all soft-tissue tumors. Radiologic evaluation is diagnostic in up to 71% of cases. These lesions are identical to subcutaneous fat on computed tomographic (CT) and magnetic resonance (MR) images and may contain thin septa. Lipomatosis represents a diffuse overgrowth of mature fat affecting either subcutaneous tissue, muscle or nerve, and imaging is needed to evaluate lesion extent. Lipoblastoma is a tumor of immature fat occurring in young children, and imaging features may reveal a mixture of fat and nonadipose tissue. Angiolipoma, myolipoma, and chondroid lipoma are rare lipomatous lesions that are infrequently imaged. Spindle cell and pleomorphic lipoma appear as a subcutaneous lipomatous mass in the posterior neck or shoulder, with frequent nonadipose components. Hibernoma appears as a lipomatous mass with serpentine vascular elements. Benign lipomatous lesions affecting bone, joint, or tendon sheath include intraosseous lipoma, parosteal lipoma, liposclerosing myxofibrous tumor, discrete lipoma of joint or tendon sheath, and lipoma arborescens. Intraosseous and parosteal lipoma have a pathognomonic CT or MR appearance, with fat in the marrow space or on the bone surface, respectively. Liposclerosing myxofibrous tumor is a rare intermixed histologic lesion commonly located in the medullary canal of the intertrochanteric femur. Benign lipomatous lesions may occur focally in a joint or tendon sheath or with diffuse villonodular proliferation in the synovium (lipoma arborescens) and are diagnosed based on location and identification of fat. Understanding the spectrum of appearances of the various benign musculoskeletal lipomatous lesions improves radiologic assessment and is vital for optimal patient management.

Index Terms: Bone neoplasms, 40.363 • Lipoma and lipomatosis, 40.363 • Soft tissues, neoplasms, 40.363

This article has been cited by other articles:

				E J HEFFERNAN, K LEFAIVRE, P L MUNK, T O NIELSEN, and B A MASRI Ossifying lipoma of the thigh Br. J. Radiol., August 1, 2008; 81(968): e207 - e210. [Abstract] [Full Text] [PDF]

				G. S. Stacy and L. B. Dixon Pitfalls in MR Image Interpretation Prompting Referrals to an Orthopedic Oncology Clinic RadioGraphics, May 1, 2007; 27(3): 805 - 826. [Abstract] [Full Text] [PDF]

				I-C Chiang, M-Y Jang, K-B Tsai, and T-J Hsieh Huge renal lipoma with prominent hypervascular non-adipose elements. Br. J. Radiol., October 1, 2006; 79(946): e148 - e151. [Abstract] [Full Text] [PDF]

				A.C.B.S. da Motta, D.E. Tunkel, W.H. Westra, and D.M. Yousem Imaging findings of a hibernoma of the neck. AJNR Am. J. Neuroradiol., September 1, 2006; 27(8): 1658 - 1659. [Abstract] [Full Text] [PDF]

				M. F. Blacksin, D.-H. Ha, M. Hameed, and S. Aisner Superficial Soft-Tissue Masses of the Extremities RadioGraphics, September 1, 2006; 26(5): 1289 - 1304. [Abstract] [Full Text] [PDF]

				A. G. Blum, J.-P. Zabel, R. Kohlmann, T. Batch, K. Barbara, X. Zhu, G. Dautel, and F. Dap Pathologic Conditions of the Hypothenar Eminence: Evaluation with Multidetector CT and MR Imaging. RadioGraphics, July 1, 2006; 26(4): 1021 - 1044. [Abstract] [Full Text] [PDF]

				J.-S. Hsu, W.-Y. Kang, G.-C. Liu, E.-L. Kao, M.-T. Chuang, and S.-H. Chou Giant Fibrolipoma in the Mediastinum: An Unusual Case Ann. Thorac. Surg., October 1, 2005; 80(4): e10 - e12. [Abstract] [Full Text] [PDF]

				M. D. Murphey, L. K. Arcara, and J. Fanburg-Smith From the Archives of the AFIP: Imaging of Musculoskeletal Liposarcoma with Radiologic-Pathologic Correlation RadioGraphics, September 1, 2005; 25(5): 1371 - 1395. [Abstract] [Full Text] [PDF]