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Differential Diagnosis of Benign Peripheral Lipoma from Well-Differentiated Liposarcoma on MR Imaging: Is Comparison of Margins and Internal Characteristics Useful?

Takayuki Ohguri1, Takatoshi Aoki1, Masanori Hisaoka2, Hideyuki Watanabe1, Katsumi Nakamura1, Hiroshi Hashimoto2, Toshitaka Nakamura3 and Hajime Nakata1

1 Department of Radiology, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan.
2 Department of Pathology and Oncology, University of Occupational and Environmental Health, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan.
3 Department of Orthopedic Surgery, University of Occupational and Environmental Health, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan.



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  		Fig. 1. —Diagram shows five types of tumor based on appearance of nonadipose components on MR imaging: type I, nonadipose component unrecognizable; type II, only thin septa (<= 2 mm) with low signal intensity detectable; type III, one or two thick septa (> 2 mm) with low signal intensity detectable; type IV, three or more thick septa detectable; and type V, nodular or patchy nonadipose component detectable.

 


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  		Fig. 2. —62-year-old woman with infiltrating lipoma of thigh. Margin of tumor is completely irregular because of neoplastic fatty tissue infiltrating surrounding muscle tissue as shown on T1-weighted sagittal MR image.

 


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  		Fig. 3. —48-year-old man with benign lipoma of shoulder (type I, nonadipose component unrecognizable). T1-weighted MR image shows uninodular tumor with well-defined and smooth margin (arrow). No recognizable nonadipose tissue is present.

 


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  		Fig. 4. —48-year-old man with benign subcutaneous lipoma of shoulder (type II, only thin septa [<= 2 mm] with low signal intensity detectable). T1-weighted MR image shows uninodular hyperintense tumor (arrow) with well-defined and smooth margin and thin septa.

 


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  		Fig. 5A. —50-year-old woman with well-differentiated liposarcoma of thigh (type III, one or two thick septa [> 2 mm] with low signal intensity detectable). T1-weighted MR image shows hyperintense multinodular tumor with well-defined and smooth margin. Some thick hypointense septa (arrows) are recognized.

 


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  		Fig. 5B. —50-year-old woman with well-differentiated liposarcoma of thigh (type III, one or two thick septa [> 2 mm] with low signal intensity detectable). Fat-suppressed T1-weighted MR image obtained after administration of gadopentetate dimeglumine shows strongly enhanced septa.

 


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  		Fig. 6A. —68-year-old man with well-differentiated liposarcoma of thigh (type IV, three or more thick septa detectable). T1-weighted coronal MR image shows hypointense thick septa (arrows) in hyperintense tumor with partially irregular margin.

 


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  		Fig. 6B. —68-year-old man with well-differentiated liposarcoma of thigh (type IV, three or more thick septa detectable). Fat-suppressed T1-weighted coronal MR image obtained after administration of gadopentetate dimeglumine shows strongly enhanced septa in hypointense tumor.

 


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  		Fig. 6C. —68-year-old man with well-differentiated liposarcoma of thigh (type IV, three or more thick septa detectable). On photomicrograph, adipose tissue is separated by thick fibrous septa. Some large and small or small blood vessels are recognized within septa. (H and E, x5)

 


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  		Fig. 6D. —68-year-old man with well-differentiated liposarcoma of thigh (type IV, three or more thick septa detectable). On photomicrograph, vacuolated lipoblasts are frequently observed near septa (arrows). (H and E, x300)

 


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  		Fig. 7. —54-year-old man with well-differentiated liposarcoma of thigh (type V, nodular or patchy nonadipose component detectable). T1-weighted coronal MR image shows hypointense nodular tissues (arrows) and many thick septa in hyperintense multinodular tumor with well-defined and smooth margin.

 

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