Imaging of fatty tumors: Distinction of lipoma and well-differentiated liposarcoma

Mark J. Kransdorf, Laura W. Bancroft, Jeffrey J. Peterson, Mark D. Murphey, William C. Foster, H. Thomas Temple

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Abstract

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 nonfatty 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 nonadipose 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 nonadipose 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 nonadipose 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 nonadipose 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 nonadipose masslike areas, and decreased percentage of fat composition.

Original languageEnglish (US)
Pages (from-to)99-104
Number of pages6
JournalRadiology
Volume224
Issue number1
DOIs
StatePublished - Jan 1 2002

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Keywords

  • Lipoma and lipomatosis
  • Lipoma and lipomatosis, CT
  • Lipoma and lipomatosis, MR
  • Liposarcoma
  • Liposarcoma, CT
  • Liposarcoma, MR
  • Soft tissues, neoplasms

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Kransdorf, M. J., Bancroft, L. W., Peterson, J. J., Murphey, M. D., Foster, W. C., & Temple, H. T. (2002). Imaging of fatty tumors: Distinction of lipoma and well-differentiated liposarcoma. Radiology, 224(1), 99-104. https://doi.org/10.1148/radiol.2241011113