肝脏单形性上皮样血管平滑肌脂肪瘤的影像表现

目的提高对肝脏单形性上皮样血管平滑肌脂肪瘤（HMEA）影像表现的认识和诊断准确率。方法对经手术病理证实的4例HMEA进行回顾性分析，讨论影像表现和病理之间的联系。结果4例HMEA中，2例误诊为肝细胞癌，1例误诊为局灶性结节增生，1例诊断正确。影像表现主要为：（1）平扫呈等低或等稍高密度的HMEA2例，强化模式呈“快进慢出”。病理特点足瘤内有丰富的窦隙状薄壁分隔微血管网，无分化成熟的脂肪细胞，1例伴厚壁的血管。（2）平扫呈低密度或低信号的HMEA2例，强化模式呈“快进快出”，中央可见粗大的动脉。病理特点为瘤中央有畸形粗大厚壁的动脉，无脂肪细胞夹杂其间。结论HMEA影像表现与病理结构直接相关，根据影像表现结合临床资料可对该病作出初步诊断，但确诊仍依赖病理组织学检查。     

Lipoblastoma and lipoblastomatosis in infancy and childhood: histopathologic, ultrastructural, and cytogenetic features

Lipoblastoma is a relatively rare tumor that occurs in infancy and early childhood and arises from embryonic white fat. Although a benign tumor, lipoblastomas tend to recur and may resemble myxoid liposarcoma. The authors report 26 cases over a 15-year period at Texas Children's Hospital. There was a slight female predilection (14F:12M). The most common symptom was a painless mass with or without increasing size. The trunk, extremities, head and neck, retroperitoneum, inguinal canal, peritoneal cavity, and lung were the tumor sites. Most tumors were circumscribed lipoblastomas and the minority were diffuse infiltrative lipoblastomatosis. Reexcision for residual or recurrent tumor was necessary more frequently in patients with lipoblastomatosis. Histopathologic examination and ultrastructural examination revealed cellular neoplasms composed of immature adipocytes with relatively well-defined septa, frequent lipoblasts, a fine vascular network, and often a myxoid appearance resembling myxoid liposarcoma. Cytogenetics was performed in 4 cases with chromosome 8q abnormality being most common. The major concern with lipoblastoma in children is to completely excise the tumor to avoid leaving residual tumor and to prevent recurrences. Confusion with myxoid liposarcoma, well-differentiated liposarcoma, and typical lipomas may occur. Although asymptomatic, lipoblastomas may cause dysfunction of other organ systems due to mass effect. Complete surgical excision with at least 2 years of follow-up is the preferred therapy.     

Lipoma of the temporal region: a rare case series

Lipomas are common benign tumours that can occur in most parts of the body. Lipomas arising from the deep temporal fat pad, found between the two layers of the deep temporal fascia, are rare, however; there has been only one documented case report to our knowledge. We describe a second case arising from the temporal fat pad in a patient treated at our unit, having previously reported the first one, and discuss the relevant anatomy and management.     

结肠脂肪瘤临床影像学分析

目的探讨结肠脂肪瘤的临床影像学诊断要点。方法对12例结肠脂肪瘤的临床、手术、病理及影像学资料进行分析。结果钡剂灌肠肿瘤呈圆形或椭圆形块影，密度低，表面黏膜无破坏。压迫或结肠收缩可见其形态改变。CT扫描为形态规则的圆形或椭圆形低密度肿块影，CT值-80--120Hu，增强扫描无强化，合并肠套叠多见。结论结肠脂肪瘤为良性肿瘤，影像学上应注意与结肠腺瘤、平滑肌瘤及结肠癌鉴别。     

Intraosseous lipoma of the frontal bone. A case report

Intraosseous lipomas are among the most uncommon bone tumors. They arise most often in the appendicular skeleton. There are very few reported cases of intraosseous lipomas within the skull bones. We report a case of intraosseous lipoma of the frontal bone with conventional radiography and CT findings.     

Giant intramuscular thigh lipoma: A case report and review of literature

IntroductionLipomas are the most common soft tissue tumor. Giant lipomas are defined by measuring at least 10 cm in diameter in one dimension or by a minimum of 1000 g. They often are asymptomatic; however, they can cause compression syndromes due to nerve damage and difficulties in walking.Presentation of caseWe described the case of a 25-year-old female with no significant medical history who began her condition two years before her consultation. The patient referred to the appearance of a non-painful mass on her right thigh with progressive growth that hinders daily activities. A simple CT scan reported a 10.3 × 8.1 × 19.6 cm adipose mass with infiltration towards the semitendinosus muscle and the biceps femoris muscle. A free margin resection of the tumor was performed, and the involved muscles were preserved. The patient had a satisfactory postoperative outcome.DiscussionLipomas are common benign soft tissue tumors that arise from fatty tissue and may challenge surgical management due to their extension and dimensions; they often require delicate surgical intervention due to their potential risk of malignant transformation. We believe surgical pathologists and radiologists must draw attention to muscle involvement and the infiltrative pattern.ConclusionGiant lipomas should always raise awareness of malignant transformation. Radiological guidance should provide enough evidence to decide whether to do a biopsy or not; hence, saving the patient an extra invasive procedure. We recommend taking at least 1 cm of border margin while removing these tumors to avoid local recurrence.     

Axillary Giant Lipoma: a Case Report

Lipoma are the most frequent mesenchymal soft tissue tumours but rarely present huge sizes in their cutaneous localization. Some cases of so-called “giant lipomas” have been reported in the literature and here is presented a giant lipoma of the axillary area which is, to our best knowledge, the second report of such a giant lipoma in this localization.     

Carotid sheath lipoma: first case report in the English literature

Lipomas are the most commonly encountered benign mesenchymal tumour, arising in any location where fat is normally present. Lipomas in the head and neck are rare in all age groups. Cases of vascular sheath lipomas in the femoral region have only been reported in adults. In children, vascular sheath lipomas have not been described to date. We report the first case of a carotid sheath lipoma in a seven-year-old boy. He had a non-tender soft mass with ill defined borders occupying the left upper part of the neck. Magnetic resonance imaging showed a mass at the bifurcation of the left common carotid artery without involving the same. The mass was hyperintense on T1 and T2 weighted sequences, suggestive of a lipoma. The lipoma was enucleated after incising the carotid sheath, safeguarding its contents. Histopathology confirmed it as a lipoma.     

Synovial lipoma arborescens of the hip

Summary Lipoma arborescens is a rare intra-articular tumor usually found in the knee joint. The reported lesion involved the inferomedial recess of the right hip synovium, in a 29-year-old male. The clinical findings were nonspecific. Both arthrography and computerized tomography (CT) of the hip disclosed the tumor which, on CT examination, showed an inhomogeneous low density, due to its fat content. The final diagnosis was given by histological examination of the resected mass. No recurrence was observed after one year. The long-term prognosis probably depends more on the underlying disorder of the joint than on the lipoma itself.