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Tumours of adipose tissue origin are relatively rare in the head and neck. Here, we report a case of an unfamiliar lipomatous lesion that involved the neck and mediastinum. A nil-comorbid man in his 40s presented with a slowly progressive anterior neck swelling of 3 years, which was diagnosed as lipoma by histopathological sampling. Computed tomography demonstrated the lesion to be involving parapharyngeal and retropharyngeal spaces with mediastinal extension. The lesion was removed by the transcervical approach. The final histology of the excised specimen, with immunohistochemistry for mouse double minute 2 (MDM2) and p16, suggested an atypical lipomatous tumour (ALT). This report accentuates the occurrence of this rare neoplasm in the neck, which often mimics lipoma clinically. Although radiology can demonstrate suggestive features, histology with MDM2 and/or p16 positivity can confirm the diagnosis of ALT as against the lipoma. A successful transcervical excision, despite the deeper extension of the lesion between the critical structures of the neck and mediastinum, demonstrates the non-infiltrating nature of the tumour., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Gastric lipomas are rare tumours accounting for 2-3% of all benign gastric tumours. These are usually submucosal in origin but in rare cases may be subserosal in origin. Although a majority of gastric lipomas are asymptomatic and usually detected incidentally, occasionally these can cause abdominal pain, dyspeptic disorders, obstruction, invagination and haemorrhages. In the literature, only 200 cases of gastric lipomas have been reported so far. We report a case of a 56-year-old female with a submucosal symptomatic gastric lipoma presenting with disabling dyspeptic symptoms., (2016 BMJ Publishing Group Ltd.)

We report the case of a 69-year-old woman who was referred to our dermatology office by her primary care physician for evaluation of a subcutaneous mass overlying the right mid sternum, which was a suspected lipoma. The mass was asymptomatic and had been present for approximately 2 weeks. The patient had undergone an aortic valve replacement approximately 2.5 years prior for treatment of an ascending aortic aneurysm. Physical examination revealed a mass located at the site of the thoracotomy scar. She was referred for an ultrasound and computed tomography angiography. Results of computed tomography angiography were consistent with a type V endoleak, and the patient was then referred to a cardiothoracic surgeon for treatment. Our case represents an unusual entity for presentation at a dermatology clinic, but endoleaks can have dire consequences if they are not recognized and treated appropriately. Dermatologists should be aware of the clinical presentation of endoleaks and this article explains the causes.

Hibernomas are rare benign tumors that may present in the head and neck in an unusual manner similar to more common malignant tumors such as lymphoma. Our case report describes several characteristics of a patient and benign tumor presentation that is atypical for the usual presentation of hibernomas as reviewed in the literature. Although hibernomas are rare, our report and review of the literature highlights a particular patient population and important key findings that should make one consider these benign tumors in the differential diagnosis of a young patient presenting with a neck mass., (© 2014 The American Laryngological, Rhinological and Otological Society, Inc.)

A spindle cell lipoma (SCL) is a relatively common tumor that can be challenging to the radiologist, pathologist, or surgeon to diagnose, particularly when internal fat content is scant or absent. Although these lesions may be found at various locations, the typical presentation for this lesion is a well-circumscribed and non-aggressive subcutaneous mass in the posterior neck presenting in a middle-aged to elderly man. In this article, the typical and atypical imaging characteristics of a spindle cell lipoma (SCL) will be reviewed. Knowledge of the common imaging and pathologic features of SCLs can help suggest the diagnosis and guide patient management.

Purpose: Intracranial lipomas are rare congenital malformations. The most common location of intracranial lipoma is the midline cerebral structures. The most frequently seen symptoms are headaches, seizures, psychomotor retardation and cranial nerve deficits. This study aimed to evaluate the clinical and radiological findings of 14 patients with intracranial lipoma., Materials and Methods: The study comprised 14 patients diagnosed with intracranial lipoma from computed tomography and magnetic resonance imaging taken after presentation at our hospital with headaches or seizures between January 2008 and April 2012. The cranial CT and MR images were evaluated by two experienced specialist radiologists. The lipoma localisation, size, morphology, any concomitant anomalies and findings of compression were recorded., Results: The study comprised 14 patients diagnosed with intracranial lipoma. The lipoma was observed to be located pericallosal, adjacent to the mamillary body and the optic chiasm, interhemispheric, in the quadrigeminal cistern and sylvian fissure. 3 patients had a history of seizures. The others had headaches., Conclusions: If there are no concomitant central nervous system (CNS) anomalies, there are no significant clinical or neurological findings apart from headaches.

Objective: Hibernoma is a benign neoplasm comprised of brown fat and characteristic hibernoma cells often occurring in adults with proximal extremity/truncal predilection. Limited reports regarding imaging appearance and clinicopathological features of this rare tumor are available. Four histological subtypes have been described. We present nine patients with hibernoma evaluating preoperative imaging findings (eight MRI; one PET, CT), which may distinguish hibernoma from more common benign or low-grade lipomatous neoplasms and attempt to correlate imaging with histological subtype. Clinicopathological data of 14 patients are presented., Materials and Methods: Following IRB approval, retrospective review identified 14 patients from our institution between 2000 and 2012. Preoperative imaging, pathology, and medical records were reviewed. We tested the reader's ability to distinguish hibernoma from lipoma and atypical lipomatous tumor (ALT) at preoperative MRI based on specific imaging criteria. In a separate test, another reader attempted to predict histological subtype. Diagnostic accuracy was recorded., Results: Six men and eight women with a mean age of 53 years were identified. Tumors involved the thigh (4), buttock (3), paraspinal muscles (3), retroperitoneum (2), shoulder (1), and knee (1). Eleven underwent margin negative resection; three excisional biopsy. When asked to differentiate hibernoma from lipoma and ALT, readers correctly identified 80 %, 80 %, and 100 % of hibernomas. Specific histological subtype was accurately predicted in most cases. Mean follow-up was 38 months with no local recurrences or metastases., Conclusions: Hibernomas can be difficult to differentiate from other lipomatous neoplasms, but identification of certain imaging features, common location, and patient demographics can improve preoperative confidence. Given benignity, accurate prospective diagnosis may affect treatment planning and surveillance strategy.

Tumour-to-tumour metastasis is a rare, but well-recognised occurrence. This case report documents the metastasis of a primary laryngeal leiomyosarcoma to a hibernoma. We believe that this is the first recorded case of leiomyosarcoma metastasising to another neoplasm, and the first recorded case of a hibernoma acting as a recipient tumour for metastasis. This case study emphasises the importance of re-imaging a known benign mass in the presence of new symptoms in a patient with underlying malignancy, to ensure prompt diagnosis and management of potentially treatable metastasis. The imaging findings including whole body magnetic resonance imaging (MRI) staging, macroscopic and histological features are presented.

Intracranial lipomas are described as a rare finding. In this small retrospective analysis of 50 cases undergoing brain CT for various reasons small intracranial lipomas where found in nine patients. In contrast to previous reports lipomas may be a frequent finding on CT imaging of the brain. In particular, these small lipomas seem to be incidental findings lacking clinical relevance. Radiologists should be aware of intracranial lipomas to establish proper differential diagnosis.

Introduction: Spindle cell lipoma (SCL) is an uncommon benign lipomatous tumor, most commonly occurring in the posterior neck and shoulder. The purpose of this study was to investigate the CT and MR imaging features of SCL in the head and neck., Methods: CT (n = 5) and MR (n = 3) images of seven patients (five men and two women; mean age, 54 years) with surgically proven SCL in the head and neck were retrospectively reviewed. The location and morphologic characteristics of SCL were documented as well., Results: Six lesions were well-defined and located in the subcutaneous fat of the posterior neck (n = 4), anterior neck (n = 1), and buccal space (n = 1). One lesion was ill-defined and located deeply in the supraclavicular fossa, infiltrating the adjacent shoulder muscles. Intratumoral fat was identified in five lesions in various amounts. Compared with the adjacent subcutaneous fat, intratumoral fat was slightly hyperattenuated on CT scans and slightly hypointense on T1-weighted MR images. In five of six lesions in which postcontrast CT and/or MR images were obtained, significant enhancement was seen in the nonadipose component of the lesion., Conclusion: Various components of the adipose and nonadipose tissues may cause difficulty differentiating between SCL and other adipocytic tumors including liposarcoma radiologically. Although nonspecific, the radiologist should know the various imaging features of SCL, because the tumor can be cured by simple excision.

Lipomas are the most common benign mesenchymal tumour. Thirteen percent of lipomas are seen in head and neck region. Anterior neck lipoma is a rare one. Anterior neck lipoma with mediastinal extension is extremely rare. We are presenting a case of 52 years old male reported to Central Referral Hospital, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim with complains of swelling in left side of neck for last 18 months along with occasional history of dyspnoea. Physical examination, ultrasound, computed tomography and fine needle aspiration cytology are in favor of lipoma. Due to its location up to the anterior mediastinum, the surgery could not be done in this hospital and patient was referred to higher center having cardiothoracic surgical back up.

Lipomas of the colon are relatively rare benign tumors. Colo-colonic intussusception is an unusual complication of colonic lipoma. We report the case of a 79-year-old man who presented with spasmodic, self-limiting abdominal pain associated with rectal bleeding. Colonoscopy revealed a submucosal mass suggestive of a benign tumor but that was too large for endoscopic resection. CT scan demonstrated an endoluminal fatty mass in the transverse colon, typical of lipoma, and suggested colo-colonic intussusception due to the mass. The mass was removed laparoscopically. Recovery was uneventful., (Copyright © 2012. Published by Elsevier Masson SAS.)

Osteolipoma is a rare variant of lipoma consisting of mature adipose tissue and mature lamellar bone. The presence of non-fatty elements may lead to a wide differential diagnosis on radiology including benign and malignant lipomatous and nonlipomatous entities. The pathological diagnosis is also confounded by the presence of heterologous differentiation. Fortunately, most lipomas harbor classic cytogenetic aberrations, and the finding of translocations involving 12q13-15 may aid in the correct diagnosis. We report three cases of osteolipoma with radiological, histological, and cytogenetic correlation.

Cardiac lipomas are rare, mostly asymptomatic, and usually found incidentally during noncardiac examinations; however, they also can be symptomatic, depending on their size and location. Here, we report a case of surgically proved pericardial lipoma that was big and for which cardiac structures were substantially altered. The combination of CT imaging and ultrasonography enabled a precise diagnosis in terms of localization, tissue characterization, and complications of the tumor. The origin of the tumor, however, remains undetermined despite a series of postoperative CT scan and ultrasound examinations.

Nasopalpebral lipoma-coloboma syndrome is characterized by nasopalpebral lipoma and eyelid coloboma. We report a case of a 16-year-old Indian girl who reported to us with this rare syndrome. Computed tomography scan showed a significantly hypodense lesion on the right side of nose which was confirmed to be a lipoma on histopathological examination. This condition should be included in differential diagnosis of conditions with congenital eyelid coloboma.

Background and Purpose: Subconjunctival fat prolapse and dermolipoma of the orbit are unfamiliar to radiologists and yet should be differentiated because their treatments are different. The purpose of this study was to investigate the CT and MR imaging findings that distinguish these 2 conditions., Materials and Methods: Between 1995 and 2009, we found 33 patients (27 men, 6 women; mean age, 63 years) with surgically proved subconjunctival fat prolapse and 27 patients (3 males, 24 females; mean age, 17 years) with dermolipoma in our hospital. Among them, 8 patients with subconjunctival fat prolapse and 6 patients with dermolipoma underwent CT and/or MR imaging examinations. We retrospectively reviewed CT scans and MR images in these patients., Results: In all of the 8 patients with subconjunctival fat prolapse, CT and MR images demonstrated the herniated fat at the superotemporal epibulbar area, continuous with the intraconal fat, extending forward between the lateral wall of the globe medially and the lateral rectus muscle and the lacrimal gland laterally, either bilaterally (n = 7) or unilaterally (n = 1). In contrast, all 6 patients with dermolipoma had a unilateral, crescent- (n = 5), or triangle-shaped (n = 1) fatty mass at the temporal or superotemporal epibulbar area, which lay on the lateral wall of the globe, anterior to the insertion of the lateral rectus muscle and medial to the lacrimal gland, without connection to the intraconal fat., Conclusions: The characteristic CT and MR imaging findings may help easily differentiate subconjunctival fat prolapse and dermolipoma, both of which usually present as an epibulbar fatty mass in the lateral canthal area.

Pleural disease is a problem of global significance which causes significant morbidity and mortality. Pleural disease is usually first suspected on chest x-ray but further imaging, often ultrasound, is usually required as part of the diagnostic work-up. Complex imaging with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT are less often performed but are routinely required in patients with mesothelioma and occasionally required in patients with pleural infection and other pleural diseases. Cross-sectional imaging may be used to suggest the diagnosis of pleural disease, quantify disease severity, guide biopsy, and even predict prognosis. This review will focus on the contributions of CT, MRI, and PET to the management of pleural disease with discussion of their relative strengths and weaknesses., (Copyright © 2010 Wiley-Liss, Inc.)

The CT and MR imaging features of the main cardiac tumors will be reviewed. Cross-sectional imaging features may help differentiate between cardiac tumors and pseudotumoral lesions and identify malignant features. Based on clinical features, imaging findings are helpful to further characterize the nature of the lesion. CT and MR imaging can demonstrate the relationship of the tumor with adjacent anatomical structures and are invaluable in the presurgical work-up and postsurgical follow-up.

Aim: To analyze the clinical and imaging features of the small intestinal lipomas and to evaluate the diagnostic value of multi-slice computed tomography (CT) enterography., Methods: Fourteen cases (one had two intestinal lesions) of surgically confirmed lipomas of the small intestine were retrospectively analyzed. The location, size, clinical and radiological aspects were discussed., Results: Twelve patients presented with abdominal pain, of whom three complained of paroxysmal colic. Melena or bloody stools was mentioned in five cases. One lesion was detected incidentally during routine physical examination. One lesion was found unexpectedly during the preoperational evaluation for cholecystitis. Examination of the abdomen revealed palpable masses in four cases. Precontrast CT scan showed round or oval well-defined hypo-intense intraluminal masses with the attenuation ranging from -130 HU to -60 HU. On contrast enhancement CT scan, no striking enhancement was seen., Conclusion: The small intestinal lipomas are rare and difficult to diagnose merely based on clinical manifestations, while the characteristic features at small intestinal CT enterography can help establish reliable prospective diagnoses.

Primary cardiac tumours are rare, and metastases to the heart are much more frequent. Myxoma is the commonest benign primary tumour and sarcomas account for the majority of malignant lesions. Clinical manifestations are diverse, non-specific, and governed by the location, size, and aggressiveness. Imaging plays a central role in their evaluation, and familiarity with characteristic features is essential to generate a meaningful differential diagnosis. Cardiac magnetic resonance imaging (MRI) has become the reference technique for evaluation of a suspected cardiac mass. Computed tomography (CT) provides complementary information and, with the advent of electrocardiographic gating, has become a powerful tool in its own right for cardiac morphological assessment. This paper reviews the MRI and CT features of primary and secondary cardiac malignancy. Important differential considerations and potential diagnostic pitfalls are also highlighted.

An asymptomatic 53-year-old woman was referred to our hospital with a slow-growing intrathoracic tumor after 3 years observation. Chest computed tomography (CT) and magnetic resonance imaging (MRI) showed an intrathoracic crescent-shaped mass measuring 13 x 2.5 cm along the left chest wall. Fatty contents were suggested. Surgical resection was successfully performed by video-assisted thracoscopic surgery. At operation, a yellowish, thinly encapsulated, 10 cm tumor was attached with its pedicle 2.5 cm in diameter to the pleura of the 7th intercostal space. The lesion was a soft mass, pedunculated and numerously lobulated, that caused the crescent form of the mass on chest CT and MRI. Histopathological examination revealed mature lipoma.

Lipomas are common benign mesenchymal neoplasms documented in literature. This study aimed to describe the computed tomographic (CT) and magnetic resonance imaging (MRI) findings of gastrointestinal system lipomas, all of which are incidentally found in routine abdominal imaging studies. Lipomas were depicted as homogeneous, nonenhancing, well-marginated lesions consistent with adipose tissue on CT and MRI. The density measurements on CT images consistent with fat are virtually diagnostic. Lipomas can incidentally be found and should be considered in the differential diagnosis of soft tissue gastrointestinal system-related masses. Computed tomographic or MRI examinations can correctly diagnose a lipoma nonoperatively, thereby allowing better treatment planning.

Purpose: Aim of the study is to demonstrate the main role of magnetic resonance imaging in the identification and characterization of lipomatous lesions of the head and neck., Materials and Methods: CT and MRI findings of 78 patients (43 male, 35 female) aged 12-80 (mean 47.5) years surgically treated for lipomatous lesions of the head and neck region between January 1995 and June 2005 were retrospectively analysed and correlated with the histological results., Results: On CT images, lipomas and fibrolipomas appeared as smooth (38/50 cases) or lobulated (12/50 cases) well-defined masses associated with moderate displacement of surrounding tissues; tumours had high signal intensity on MR T1-weighted images, with relative decreasing signal on T2-weighted images. Infiltrating lipomas appeared as expansile ill-defined masses with heterogeneous signal. Angiolipomas showed a characteristic contrast enhancement on both CT and MRI. In one case of sialolipoma, the lesion appeared markedly heterogeneous in signal. MR and CT images of Madelung's disease showed multiple symmetrical lipomatous masses involving the neck region. Intraosseous fatty lesions appeared as well-defined hypodense masses sometimes associated with cortical expansion and disruption., Conclusions: Both CT and MRI exams are useful for detecting lipomatous lesions. MRI, however, is more accurate in the evaluation of their extent and in the characterisation of uncommon lipomatous lesions of the head and neck, and intravenous administration of gadolinium better depicts the margins of the tumour and its vascularisation.

Purpose: The purpose of this study was to describe the computed tomography (CT) and magnetic resonance (MR) imaging findings of hibernoma., Materials and Methods: We retrospectively evaluated imaging findings of CT and MR examinations of six patients (three men and three woman, aged 27-48 years) with histopathological diagnosis of hibernoma., Results: On CT examination, the lesions were slightly hyperdense, and on T1- and T2-weighted MR images, they were isointense or slightly hypointense compared to the subcutaneous fat. All of these lesions showed contrast enhancement and one out of the six lesions had internal linear septations., Conclusion: Hibernoma has a wide spectrum of CT and MR imaging findings, which should be considered in differential diagnosis, especially with other lipomatous lesions.

Background: Lipoma-like liposarcomas mimic deep-seated lipomas in regard to imaging as well as histological findings and occasionally cause problems concerning diagnosis and treatment. The differences in the imaging findings among these lesions are not well defined. The purpose of this study was to elucidate the differences among the deep-seated adipocytic neoplasms including intramuscular lipoma, intermuscular lipoma, and lipoma-like liposarcoma., Methods: The imaging and clinicopathological findings of 40 intramuscular lipomas, 27 intermuscular lipomas, and 22 lipoma-like liposarcomas were evaluated, and the possibilities in the differential diagnosis were assessed., Results: Although the most frequent symptom was a palpable mass, swelling was a common symptom of intramuscular lipomas and lipoma-like liposarcomas. Imaging studies revealed dumbbell-shaped appearances among intermuscular lipomas, whereas spherical masses were characteristic of intramuscular lipomas and lipoma-like liposarcomas. Computed tomography and magnetic resonance imaging revealed fatty lesions containing streaky structures in benign lesions, and CT revealed foci of hazy amorphous density, representing spindle cell proliferation, in lipoma-like liposarcoma. Although streaky structures corresponding to entrapped muscle fibers were thick and occasionally interrupted in intramuscular lipomas, the streaky structures corresponding to areolar fibrous tissue were thin and were usually not interrupted in intermuscular lipomas. In lipoma-like well-differentiated liposarcomas, thick streaks represented entrapped muscle fibers, and thin streaks represented fibrous tissue or neoplastic spindle cell proliferation., Conclusions: The imaging findings are helpful and often afford almost pathognomonic evidence of these lesions and could help with the selection of appropriate surgery.

Lipomatous tumors of the uterus are unusual, benign neoplasms seen in postmenopausal women. Although many of the mixed-type cases such as lipoleiomyoma and fibrolipoma have been reported, pure uterine lipomas are extremely rare. In the literature, a few cases with pure uterine lipoma have been reported. We first present the advanced magnetic resonance findings of pure uterine lipoma, followed by those of ultrasonography (US) and computed tomography (CT). We markedly detected lipid peaks on the magnetic resonance spectroscopy (MRS) and the apparent diffusion coefficient value to be 0.00 due to chemical-shift effects with diffusion-weighted imaging (DWI). Although pelvic lipomatous tumors can be diagnosed with US and CT, in some cases, further workup may be required to localize the lesion. MRI may yield more valuable data for differential diagnosis. MRS and DWI findings provide additional clues on the nature of the lesion.

The lipomatous tumors of the adrenals are hormonally inactive lesions, often of a benign nature, such as myelolipomas, lipomas, angiomyolipomas, or mature teratomas, and are rarely malignant, such as liposarcomas. The importance of recognizing their characteristic radiological images, which would lead to their correct treatment, is fundamental since there has been an increase in the demonstration of this lesion, often detected incidentally. The various imaging procedures, although not allowing to formulate a histological diagnosis, nonetheless permit to determine the volume of the tumoral mass and their evolution. These two factors are of significant importance in the planning of the correct surgical procedure, while a third important factor is the proper evaluation of the symptoms presented by the patient. Regarding the treatment, on the basis of our own experience, which agrees with that of other authors, the surgical removal of any lesion greater than 5 cm is mandatory.

Sturge-Weber syndrome is one of the neurocutaneous syndromes. It is a rare, nonfamiliar disease that is characterized by facial port-wine stain, leptomeningeal angiomatosis, choroidal angioma, buphthalmos, intracranial calcification, cerebral atrophy, mental retardation, glaucoma, seizures and hemiparesis. CT and MR are complementary in the evaluation of this disease. Epilepsy is an essential feature of Sturge-Weber syndrome and it has a major significance for prognosis and treatment. We report a 2-year-old boy with Sturge-Weber syndrome who had in addition an intracranial lipoma, a temporal arachnoid cyst and a porencephalic cyst. This combination of intracranial lesions with Sturge-Weber syndrome has not been previously reported.

A 45 year-old asymptomatic man was admitted to preoperative cardiovascular evaluation for noncardiac surgery. Physical examination and ECG were normal. Transthoracic echocardiography showed a 17 x 35 mm suspicious hyperechoic mass in the interventricular septum. Multi-slice computed tomography (MSCT) was used. Volume rendered image and an axial maximal intensity projection image demonstrated a mass with a density consistent with fat tissue ( - 78 HU). The MSCT findings were diagnostic of a benign lipoma. Thus, this mass was noninvasively diagnosed as cardiac lipoma. Neither life-threatening arrhythmia on Holter monitoring nor myocardial ischemia on exercise scintigraphy was observed.Transthoracic echocardiography is usually the initial diagnostic test in patients with a suspected cardiac mass. However, its sensitivity for differentiating tissue characteristics is limited. MSCT allow for detailed delineation of intra and pericardiac masses. In conclusion, we demonstrated the value of cardiac MSCT to diagnose an interventricular lipoma.

Hibernoma is an uncommon benign fatty tumor that arises from the vestiges of fetal brown fat. We present a case report of a hibernoma of the neck in an asymptomatic 19-year-old girl and describe the important imaging findings. Computed tomography (CT) shows a well defined hypodense mass with septations. Magnetic resonance imaging (MRI) shows intermediate T1 and bright T2 signal of the mass and also demonstrates the characteristic marked contrast enhancement.

Hibernoma is a rare benign soft tissue tumor composed of remnants of fetal brown fat. It has only rarely been reported in the literature in patients ranging in age from 2 to 75 years. We present a case of multiple hibernomas occurring in a 1-month-old infant.

Objective: The objective of this article is to define the imaging characteristics of spindle cell lipoma on MRI and CT., Conclusion: The diagnosis of spindle cell lipoma should be suggested when a well-defined complex fatty mass is found in the subcutis of a middle-aged man, especially if the mass is localized to the posterior neck. Intense enhancement of the nonadipose component further supports this diagnosis.

Unlabelled: With the introduction of spiral scanning then multidetector technologies, the accuracy for diagnosing digestive tract diseases with CT has been highly improved, and CT is used more and more in the evaluation of patients with suspected gastrointestinal disorders. CT is able to demonstrate both the intramural and the extramural components of the disease, and has a major role in the preoperative staging and the follow-up. Improvements of CT protocols, such as CT-enteroclysis, or multiplanar 2D and 3D post-processing, including now techniques for "virtual endoscopy", lead to discuss new indications in which CT could now compete with conventional X-rays series and videoendoscopy. This precise study of the digestive wall, the peridigestive fat, the digestive tract blood supply, may be performed by MRI, under the condition of access to high level machines and standardized protocols. MR-enteroclysis and MR-virtual colonoscopy could be performed with much lower risk for the patient, in terms of radiation dose or contrast adverse effects. Endoluminal coils should give to MR an ultra-high resolution for analysing the different layers of the gastrointestinal wall., Learning Objectives: to review how to perform CT and MRI protocols for digestive tract imaging, to recognize the CT and MR patterns of the main digestive tract diseases, to discuss the value, limits and role of CT and MR in digestive tract diseases, to discuss the potential role of CT and MR new technological developments for digestive tract imaging in the upcoming future., Conclusion: CT is nowadays a modality of choice for digestive imaging. Improvements in technologies and indications, the necessary discussion of the risks and benefits for the patient should let the radiologists consider MRI in gastrointestinal disorders as an important part of the routine activity in clinical MRI.

Infiltrating lipoma is an uncommon mesenchymal neoplasm that characteristically infiltrates adjacent tissues and tends to recur after excision. This type of lipoma is extremely rare in the head and neck region. We report a case of a giant infiltrating lipoma of the face, studied with CT and MR imaging.

Background and Purpose: Intracranial lipomas are uncommon congenital malformations that most often are asymptomatic. A rare subset of intracranial lipomas arises within the vestibule of the inner ear, which can cause sensorineural hearing loss. We present the CT and MR imaging characteristics of lipomas within the vestibule of the inner ear and propose a pathogenetic mechanism for this malformation., Methods: We retrospectively reviewed five cases of vestibular lipoma. T1-weighted axial conventional spin-echo and T2-weighted axial fast spin-echo sequences were performed in all five cases. Four patients underwent T1-weighted fat-saturated imaging, and one underwent CT scanning with Hounsfield units measured., Results: Four female patients ranging in age from 10 to 40 years and one 26-year-old male patient had sensorineural hearing loss. Two patients had progressive high-frequency loss; one, sudden-onset high-frequency loss; and two, congenital high-frequency loss. All had lesions within the vestibule that displayed hyperintensity on T1-weighted images, isointensity to slight hypointensity on T2-weighted fast spin-echo images, hypointensity with fat saturation, and fat attenuation on CT scans. Three of the cases were associated with lipoma of the cerebellopontine angle. In none of these cases were the cerebellopontine angle and labyrinthine lipomas contiguous., Conclusion: Intravestibular lipoma is considered when a focal hyperintense lesion is identified within the vestibule of the inner ear on T1-weighted MR images. Lesion hypointensity on fat-saturated T1-weighted MR images verifies its lipomatous nature and separates it from intralabyrinthine hemorrhage or highly proteinaceous fluid.

Purpose: To review the reliability of computed tomographic (CT) and magnetic resonance (MR) imaging features in distinguishing lipoma and well-differentiated liposarcoma., Materials and Methods: CT (n= 29) and MR (n = 40) images and radiographs (n = 28) of 60 patients with histologically verified fatty tumors (35 lipomas and 25 well-differentiated liposarcomas) were retrospectively reviewed in 31 females and 29 males (mean age, 56 years; age range, 1-88 years). Images were assessed for adipose tissue content, and non-fatty component was classified (thin and/or thick septa and nodular and/or globular components) as absent, mild, moderate, or pronounced. Also assessed were signal intensity and tissue attenuation of the fatty components and non-adipose elements., Results: Statistically significant imaging features favoring a diagnosis of liposarcoma included lesion larger than 10 cm (P <.001), presence of thick septa (P =.001), presence of globular and/or nodular non-adipose areas (P =.003) or masses (P =.001), and lesion less than 75% fat (P <.001). The most statistically significant radiologic predictors of malignancy were male sex, presence of thick septa, and associated non-adipose masses, which increased the likelihood of malignancy by 13-, nine-, and 32-fold, respectively. Both lipoma and liposarcoma demonstrated thin septa and regions of increased signal intensity on fluid-sensitive MR images., Conclusion: A significant number of lipomas will have prominent non-adipose areas and will demonstrate an imaging appearance traditionally ascribed to well-differentiated liposarcoma. Features that suggest malignancy include increased patient age, large lesion size, presence of thick septa, presence of nodular and/or globular or non-adipose mass-like areas, and decreased percentage of fat composition.

Ossifying lipomas independent of bone tissue are very rare. A literature review revealed that only few cases of ossifying lipoma independent of bone tissue have been reported. None of the cases have been reported in the international radiology literature. In addition, there are no reports concerning the MRI features of this entity. We describe CT and MRI findings in a case of ossifying lipoma of the parapharyngeal space.

A uterine lipoleiomyoma is a variant of uterine myomas, however, it is rarely found in patients and the diagnosis of uterine lipoleiomyoma has always been in retrospect. Uterine lipoleiomyomas are often diagnosed preoperatively as uterine myomas or ovarian mature teratomas. The key to distinguishing the tumors from lipoleiomyomas is to ascertain the primary site of development--uterus or adnexa. When a large uterine tumor is found in a postmenopausal woman, the possibility of malignancy should be considered. Now, however, advanced modern imaging systems can provide more precise diagnoses than before. The following case illustrates how a uterine lipoleiomyoma was highly suggestive preoperatively based on typical characteristics on ultrasound and computed tomography (CT). A homogeneous hyper-echoic mass confined to the uterus on ultrasound initiated the suspiction of the tumor. In addition, the uterine mass showed lower density than water on CT which further established the possibility of a fatty tumor of the uterus. The final pathological examination results confirmed the diagnosis of lipoleiomyoma.

Primary tumours of the heart and pericardium are extremely rare. Cardiac lipomas account for only 10% of all primary cardiac tumours. A case of surgically proven pericardial lipoma demonstrated by ultrasound, CT and MRI is presented here.

Background: We describe a 4-month-old infant with a ruptured intrathoracic lipoblastoma arising from the parietal pleura and associated with a pleural effusion., Objective: The clinical presentation was rapidly evolving respiratory distress. The chest radiograph showed a large mass and a pleural effusion in the right thoracic cavity. CT demonstrated an inhomogeneous low-attenuation mass which was 7 cm in diameter and which showed areas of enhancement after intravenous contrast medium. MRI showed a fatty intrathoracic mass with intratumoral streaks and whorls, which were attributed to loose fibrovascular connective tissue on pathological examination., Results: Thoracotomy and pathological examination revealed a ruptured intrathoracic lipoblastoma arising from the parietal pleura., Conclusion: The pleural effusion might have suggested rupture of the tumour.