Imaging Features of Fat Necrosis
Lai Peng Chan1,
R. Gee2,
Ciaran Keogh2 and
Peter L. Munk2
1 Department of Diagnostic Radiology, Singapore General Hospital, Outram Rd.,
169608 Singapore.
2 Department of Radiology, Vancouver General Hospital, University of British
Columbia, 899 W. 12th Ave., Vancouver, BC, V5Z 1M9 Canada.
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Fig. 1. —79-year-old woman with mass at medial aspect of thigh and no
history of trauma. Mass was biopsied and found to be area of fat necrosis.
Axial contrast-enhanced CT scan of thigh shows hypodense lesion in
subcutaneous tissue with rim enhancement (arrow) and perilesional
stranding (arrowheads).
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Fig. 2A. —73-year-old man with recent diagnosis of carcinoma of
prostate and incidental mass in his left buttock. This mass was confirmed to
be fat necrosis after core biopsy. Axial unenhanced CT scan shows mass in
subcutaneous fat with central fatty density (arrow) and peripheral
globular component (arrowhead) with density similar to muscle
density.
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Fig. 2B. —73-year-old man with recent diagnosis of carcinoma of
prostate and incidental mass in his left buttock. This mass was confirmed to
be fat necrosis after core biopsy. Sagittal T2-weighted image (TR/TE, 2400/90)
shows lesion has central high signal intensity and low-signal-intensity rim
(arrow).
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Fig. 2C. —73-year-old man with recent diagnosis of carcinoma of
prostate and incidental mass in his left buttock. This mass was confirmed to
be fat necrosis after core biopsy. Axial fast STIR image (2500/20) shows
lesion (arrows) is hyperintense on this sequence.
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Fig. 3A. —50-year-old man with mass at posterior aspect of thigh. Fat
necrosis was confirmed after core biopsy. Axial unenhanced CT scan shows
well-defined lesion in biceps femoris muscle that has density similar to that
of subcutaneous fat, consistent with intramuscular lipoma. Amorphous cloudlike
areas of stranding (arrows) can be seen at lateral aspect of
lesion.
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Fig. 3B. —50-year-old man with mass at posterior aspect of thigh. Fat
necrosis was confirmed after core biopsy. Axial T2-weighted image (TR/TE,
2000/105) shows stranding (arrows) at lateral aspect of lesion, which
is hypointense to subcutaneous fat. Lesion otherwise mirrors signal of
subcutaneous fat on all sequences (not shown).
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Fig. 4A. —73-year-old man who presented with mass in anterolateral
thigh. After resection, mass was found to be lipoma with area of fat necrosis.
Axial T1-weighted image (TR/TE, 500/16) of distal femur shows large septated
intramuscular fat-containing lesion (arrows) with epicenter in vastus
lateralis and intermedius muscles, consistent with lipoma. Note central
hypointense serpiginous lesion (arrowhead).
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Fig. 4B. —73-year-old man who presented with mass in anterolateral
thigh. After resection, mass was found to be lipoma with area of fat necrosis.
Sagittal fat-saturated contrast-enhanced T1-weighted image (500/16) shows
homogeneous signal loss in fatty portion of lesion, enhancement of capsule and
internal septa (arrows), and rim enhancement of serpiginous portion
(arrowheads).
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Fig. 5A. —67-year-old man with enlarging mass in anterior right thigh.
This lesion was resected and found to be atypical lipoma with multiple areas
of fat necrosis. Axial unenhanced T1-weighted image (TR/TE, 500/14) shows
well-defined lobulated intramuscular mass of fat signal intensity with
internal septations. Two nodules with hypointense rims and hyperintense
centers (arrows) are present.
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Fig. 5B. —67-year-old man with enlarging mass in anterior right thigh.
This lesion was resected and found to be atypical lipoma with multiple areas
of fat necrosis. Axial fat-saturated T2-weighted fast spin-echo image
(2000/100) shows that nodules can appear hypointense (arrows) or
hyperintense (arrowheads).
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Fig. 5C. —67-year-old man with enlarging mass in anterior right thigh.
This lesion was resected and found to be atypical lipoma with multiple areas
of fat necrosis. Sagittal fat-saturated contrast-enhanced T1-weighted image
(500/14) shows homogeneous signal loss of entire lesion and all nodules
exhibiting irregular rim enhancement (arrows).
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Fig. 2D. —73-year-old man with recent diagnosis of carcinoma of
prostate and incidental mass in his left buttock. This mass was confirmed to
be fat necrosis after core biopsy. Sagittal fat-suppressed T1-weighted
gadolinium-enhanced image (500/16) shows lesion is hypointense with irregular
rim enhancement (arrows).
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Copyright © 2003 by the American Roentgen Ray Society.
