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Lipoma
Esther H. Y. Hung, MBChB, FRCR, FHKCR, FHKAM (Radiology); James F. Griffith, MD, MRCP, FRCR
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Fatty tumor
          • Definitions

            • Benign
              • Lipoma: Benign soft tissue tumor composed of mature adipose tissue
              • Angiolipoma: Lipoma in which small capillary-sized vessels containing microthrombi transverse tumor
              • Lipomatosis: Diffuse infiltrative overgrowth of mature adipose tissue, completely or partially encapsulated
              • Lipomatosis of nerve: Median > > > other nerves ± localized mesenchymal overgrowth
              • Spindle cell lipoma: Mixture of fat and spindle cells; more common in head and neck subcutaneous tissues and adult males
              • Lipoblastoma: Admixture of mature and immature adipocytes; more common in extremities and children < 3 years old
              • Hibernoma: Tumor of brown (thermogenic) fat similar to that found in hibernating animals; > subcutaneous tissues of adults, especially lower neck, mediastinum, and upper dorsal region
              • Chondroid lipoma: Adult females, shoulder or pelvic girdle, may calcify
              • Myolipoma: Benign tumor exhibiting features of mature smooth muscles and mature adipose tissue
              • Lipoma arborescens: Subsynovial fatty proliferation, knee > > > ankle or hip; may occur in tendon sheath
            • Intermediate
              • Well-differentiated liposarcoma: Slow-growing, usually deep-seated tumor that does not metastasize but is prone to local recurrence; dedifferentiation risk: 6%
            • Malignant
              • Dedifferentiated liposarcoma: Deep-seated and large with significant (> 25%) nonfatty component; malignant potential
              • Myxoid liposarcoma: Myxoid tumor either low grade (< 5% round cell component) or high grade (> 5% round cell component)
              • Pleomorphic liposarcoma: Large mass with myxoid, necrotic, fatty, and hemorrhagic components

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Gupta P et al: Spectrum of fat-containing soft-tissue masses at MR imaging: the common, the uncommon, the characteristic, and the sometimes confusing. Radiographics. 36(3):753-66, 2016
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Fatty tumor
                                                • Definitions

                                                  • Benign
                                                    • Lipoma: Benign soft tissue tumor composed of mature adipose tissue
                                                    • Angiolipoma: Lipoma in which small capillary-sized vessels containing microthrombi transverse tumor
                                                    • Lipomatosis: Diffuse infiltrative overgrowth of mature adipose tissue, completely or partially encapsulated
                                                    • Lipomatosis of nerve: Median > > > other nerves ± localized mesenchymal overgrowth
                                                    • Spindle cell lipoma: Mixture of fat and spindle cells; more common in head and neck subcutaneous tissues and adult males
                                                    • Lipoblastoma: Admixture of mature and immature adipocytes; more common in extremities and children < 3 years old
                                                    • Hibernoma: Tumor of brown (thermogenic) fat similar to that found in hibernating animals; > subcutaneous tissues of adults, especially lower neck, mediastinum, and upper dorsal region
                                                    • Chondroid lipoma: Adult females, shoulder or pelvic girdle, may calcify
                                                    • Myolipoma: Benign tumor exhibiting features of mature smooth muscles and mature adipose tissue
                                                    • Lipoma arborescens: Subsynovial fatty proliferation, knee > > > ankle or hip; may occur in tendon sheath
                                                  • Intermediate
                                                    • Well-differentiated liposarcoma: Slow-growing, usually deep-seated tumor that does not metastasize but is prone to local recurrence; dedifferentiation risk: 6%
                                                  • Malignant
                                                    • Dedifferentiated liposarcoma: Deep-seated and large with significant (> 25%) nonfatty component; malignant potential
                                                    • Myxoid liposarcoma: Myxoid tumor either low grade (< 5% round cell component) or high grade (> 5% round cell component)
                                                    • Pleomorphic liposarcoma: Large mass with myxoid, necrotic, fatty, and hemorrhagic components

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Gupta P et al: Spectrum of fat-containing soft-tissue masses at MR imaging: the common, the uncommon, the characteristic, and the sometimes confusing. Radiographics. 36(3):753-66, 2016