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The differential imaging features of fat-containing tumors in the peritoneal cavity and retroperitoneum: the radiologic-pathologic correlation.

Shin NY, Kim MJ, Chung JJ, Chung YE, Choi JY, Park YN - Korean J Radiol (2010)

Bottom Line: At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques.Thus, the questions about the treatment methods have become increasingly important.Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.

ABSTRACT
There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson's capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

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30-year-old woman with pathologically proven pleomorphic liposarcoma.A. Axial contrast-enhanced CT scan shows soft tissue tumor with heterogeneous enhancement.B. Axial T2-weighted MR image shows heterogeneous, high signal intense tumor. Signal intensity is similar to or slightly lower than that of subcutaneous fat.
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Figure 4: 30-year-old woman with pathologically proven pleomorphic liposarcoma.A. Axial contrast-enhanced CT scan shows soft tissue tumor with heterogeneous enhancement.B. Axial T2-weighted MR image shows heterogeneous, high signal intense tumor. Signal intensity is similar to or slightly lower than that of subcutaneous fat.

Mentions: Pleomorphic liposarcoma is the least common subtype; it is a high-grade, very aggressive tumor. On microscopy, pleomorphic liposarcoma is characterized by pleomorphic spindle cells and giant cells, as well as sheets of pleomorphic lipoblasts (4). Pleomorphic liposarcoma shows CT attenuation approximating that of muscle (6). Pleomorphic liposarcoma exhibits ill-defined and soft-tissue signal intensity equal to that of muscle on the T1-weighted spin-echo MR images and this is equal to that of fat on the T2-weighted spin-echo MR images without characteristic manifestations (9) (Fig. 4). There are no characteristic signals on MRI, so it is very difficult to differentiate this tumor from other retroperitoneal soft tissue tumors.


The differential imaging features of fat-containing tumors in the peritoneal cavity and retroperitoneum: the radiologic-pathologic correlation.

Shin NY, Kim MJ, Chung JJ, Chung YE, Choi JY, Park YN - Korean J Radiol (2010)

30-year-old woman with pathologically proven pleomorphic liposarcoma.A. Axial contrast-enhanced CT scan shows soft tissue tumor with heterogeneous enhancement.B. Axial T2-weighted MR image shows heterogeneous, high signal intense tumor. Signal intensity is similar to or slightly lower than that of subcutaneous fat.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864861&req=5

Figure 4: 30-year-old woman with pathologically proven pleomorphic liposarcoma.A. Axial contrast-enhanced CT scan shows soft tissue tumor with heterogeneous enhancement.B. Axial T2-weighted MR image shows heterogeneous, high signal intense tumor. Signal intensity is similar to or slightly lower than that of subcutaneous fat.
Mentions: Pleomorphic liposarcoma is the least common subtype; it is a high-grade, very aggressive tumor. On microscopy, pleomorphic liposarcoma is characterized by pleomorphic spindle cells and giant cells, as well as sheets of pleomorphic lipoblasts (4). Pleomorphic liposarcoma shows CT attenuation approximating that of muscle (6). Pleomorphic liposarcoma exhibits ill-defined and soft-tissue signal intensity equal to that of muscle on the T1-weighted spin-echo MR images and this is equal to that of fat on the T2-weighted spin-echo MR images without characteristic manifestations (9) (Fig. 4). There are no characteristic signals on MRI, so it is very difficult to differentiate this tumor from other retroperitoneal soft tissue tumors.

Bottom Line: At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques.Thus, the questions about the treatment methods have become increasingly important.Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea.

ABSTRACT
There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson's capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.

Show MeSH
Related in: MedlinePlus