Lipoma

 

Lipoma MRI 1Lipoma Thigh MRILipoma Clinical 1

 

Definition

 

Benign adipose tumour

 

Epidemiology

 

Most common mesenchymal neoplasm

- arise from normal fat

 

40 - 60 years of age

 

Clinical

 

80% subcutaneous

 

Well circumscribed mobile, round mass

 

Upper back, shoulder and thigh most common sites

 

Multiple in 5% of cases

 

Condition

 

Durcen's Disease 

- multiple lipoma subcutaneous disease

 

MRI

 

Same signal intensity as surrounding fat

 

Lipoma Thigh MRI

 

Lipoma Intramuscular0001Lipoma Intramuscular0002

Intra-muscular lipoma

 

Lipoma MRI 1Lipoma MRI 2Lipoma MRI 3

Intra-muscular lipoma

 

Angiolipoma MRI0002Angiolipoma MRI0001

 

Classification

 

Divided into 5 subtypes

1.  Simple lipoma

2.  Spindle Cell Lipoma - variable number of benign spindle cells

3.  Pleomorphic Lipoma

4.  Intramuscular

5.  Angiolipoma - tender / painful

 

Pathology

 

Lipoma Clinical 1Lipoma Clinical Photo 2

 

Well circumscribed round to ovoid masses

- homogenous pale to bright yellow on cut surface

 

Histology

 

Same as normal fat

- sheets of mature fat cells ovoid to round in shape

- contain single fat droplet with peripheral nucleus 

- capillary like vessels are occasionally seen between lobules

 

Management

 

Biopsy

 

Differential diagnosis liposarcoma

 

Large lesions

Growth

Heterogenous appearance

Deep to fascia

 

Boneschool page on liposarcoma

 

Marginal resection

 

Recurrence uncommon