Skeletal Radiol (2014) 43:191–196 DOI 10.1007/s00256-013-1765-6
SCIENTIFIC ARTICLE
MR imaging features of spindle cell lipoma Anand Kirwadi & Rehan Abdul-Halim & Malee Fernando & Adrian Highland & Nikhil Kotnis
Received: 19 July 2013 / Revised: 16 October 2013 / Accepted: 17 October 2013 / Published online: 16 November 2013 # ISS 2013
Abstract Objective To assess the MR imaging features of spindle cell lipomas (SCL) and to compare these appearances directly with the histopathological findings. Materials and methods A retrospective review of our soft tissue tumor database was performed. This yielded 1,327 histologically proven lipomas, of which 25 were confirmed as being SCLs. Fourteen of the 25 patients had MR examinations available for review and only these patients were included in our study. Lesions were assessed at MR examination for the degree of internal fat signal content with grade 0 representing 0 % fat signal and grade 4 100 % fat signal. The degree of fat suppression and contrast-enhancement pattern were also recorded. The excision specimens were independently reviewed by a consultant histopathologist. The histology specimens were assessed for the amount of internal fat and non-adipose tissue and graded using the same scale applied for the imaging. Where core needle biopsy (CNB) was performed, the CNB specimens were also examined for positive features of SCL. Results In our study, 93 % (13/14) of our patients were male and the average age was 58 years. 65 % (9/14) of the lesions A. Kirwadi : R. Abdul-Halim : A. Highland : N. Kotnis (*) Radiology Department, Sheffield Teaching Hospitals NHS Trust, Herries Road, Sheffield S5 7AU, UK e-mail: [email protected] A. Kirwadi e-mail: [email protected] R. Abdul-Halim e-mail: [email protected] A. Highland e-mail: [email protected] M. Fernando Histopathology Department, Sheffield Teaching Hospitals NHS Trust, Herries Road, Sheffield S5 7AU, UK e-mail: [email protected]
presented in the upper back, shoulder, or neck. All lesions were subcutaneous. 35 % (5/14) of the SCLs demonstrated grade 3 (>75 %) or grade 4 (100 %) fat signal on MR examination. 35 % (5/14) of the lesions had grade 2 (25– 75 %) fat signal and 29 % (4/14) of the lesions demonstrated grade 0 (0 %) or grade 1 (75 %) or grade 4 (100 %) fat signal on MR examination.
Results Of our study patients, 93 % (13/14) were male. The mean age of these patients was 58 years (range, 31–76 years). All the Fig. 3 A 63-year-old male with SCL in the left nape of the neck. Axial T1W (a), axial T1 FS (b), and axial T1W FS post-contrast (c) images showing a wellcircumscribed, subcutaneous, globular, predominantly fatty (grade 3) lesion with enhancement of the non-fatty components. H&E stain×100 magnification diagram (d) showing admixture of bland spindle cells and mature adipocytes (>75 %)
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Skeletal Radiol (2014) 43:191–196
Fig. 4 A 70-year-old male with SCL in the right side of the neck. Coronal T1W (a), T2W FS (b), and T1W FS post-contrast (c) images
showing a globular, subcutaneous, (grade 3) mass lesion with enhancement of the septae
Two lesions showed grade 4 (100 %) entirely homogenous fat signal, 35 % (5/14) lesions had grade 2 (25–75 %) fat signal, and 29 % (4/14) lesions demonstrated grade 0 (0 %) or grade 1 (
SCIENTIFIC ARTICLE
MR imaging features of spindle cell lipoma Anand Kirwadi & Rehan Abdul-Halim & Malee Fernando & Adrian Highland & Nikhil Kotnis
Received: 19 July 2013 / Revised: 16 October 2013 / Accepted: 17 October 2013 / Published online: 16 November 2013 # ISS 2013
Abstract Objective To assess the MR imaging features of spindle cell lipomas (SCL) and to compare these appearances directly with the histopathological findings. Materials and methods A retrospective review of our soft tissue tumor database was performed. This yielded 1,327 histologically proven lipomas, of which 25 were confirmed as being SCLs. Fourteen of the 25 patients had MR examinations available for review and only these patients were included in our study. Lesions were assessed at MR examination for the degree of internal fat signal content with grade 0 representing 0 % fat signal and grade 4 100 % fat signal. The degree of fat suppression and contrast-enhancement pattern were also recorded. The excision specimens were independently reviewed by a consultant histopathologist. The histology specimens were assessed for the amount of internal fat and non-adipose tissue and graded using the same scale applied for the imaging. Where core needle biopsy (CNB) was performed, the CNB specimens were also examined for positive features of SCL. Results In our study, 93 % (13/14) of our patients were male and the average age was 58 years. 65 % (9/14) of the lesions A. Kirwadi : R. Abdul-Halim : A. Highland : N. Kotnis (*) Radiology Department, Sheffield Teaching Hospitals NHS Trust, Herries Road, Sheffield S5 7AU, UK e-mail: [email protected] A. Kirwadi e-mail: [email protected] R. Abdul-Halim e-mail: [email protected] A. Highland e-mail: [email protected] M. Fernando Histopathology Department, Sheffield Teaching Hospitals NHS Trust, Herries Road, Sheffield S5 7AU, UK e-mail: [email protected]
presented in the upper back, shoulder, or neck. All lesions were subcutaneous. 35 % (5/14) of the SCLs demonstrated grade 3 (>75 %) or grade 4 (100 %) fat signal on MR examination. 35 % (5/14) of the lesions had grade 2 (25– 75 %) fat signal and 29 % (4/14) of the lesions demonstrated grade 0 (0 %) or grade 1 (75 %) or grade 4 (100 %) fat signal on MR examination.
Results Of our study patients, 93 % (13/14) were male. The mean age of these patients was 58 years (range, 31–76 years). All the Fig. 3 A 63-year-old male with SCL in the left nape of the neck. Axial T1W (a), axial T1 FS (b), and axial T1W FS post-contrast (c) images showing a wellcircumscribed, subcutaneous, globular, predominantly fatty (grade 3) lesion with enhancement of the non-fatty components. H&E stain×100 magnification diagram (d) showing admixture of bland spindle cells and mature adipocytes (>75 %)
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Skeletal Radiol (2014) 43:191–196
Fig. 4 A 70-year-old male with SCL in the right side of the neck. Coronal T1W (a), T2W FS (b), and T1W FS post-contrast (c) images
showing a globular, subcutaneous, (grade 3) mass lesion with enhancement of the septae
Two lesions showed grade 4 (100 %) entirely homogenous fat signal, 35 % (5/14) lesions had grade 2 (25–75 %) fat signal, and 29 % (4/14) lesions demonstrated grade 0 (0 %) or grade 1 (
