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Imaging Characteristics of Spindle Cell Lipoma

Laura W. Bancroft1, Mark J. Kransdorf1,2, Jeffrey J. Peterson1, Murali Sundaram3, Mark D. Murphey2,4,5 and Mary I. O'Connor6

1 Department of Radiology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224-3899.
2 Department of Radiologic Pathology, Armed Forces Institute of Pathology, Walter Reed Army Medical Center, Bldg. #54, 6825 16th St., NW, Washington, DC 20306-6000.
3 Department of Radiology, Mayo Clinic, 200 1st St., Rochester, MN 55905.
4 Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814-4799.
5 Department of Radiology, University of Maryland School of Medicine, 22 S Greene St., Baltimore, MD 21201-1595.
6 Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224-3899.



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Fig. 1A. 53-year-old man with spindle cell lipoma in subcutaneous adipose tissue of posterior neck. Sagittal unenhanced T1-weighted image (TR/TE, 550/13) shows ovoid, well-circumscribed tumor with fairly equal ratio of adipose and nonadipose tissue.

 


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Fig. 1B. 53-year-old man with spindle cell lipoma in subcutaneous adipose tissue of posterior neck. Sagittal fast spin-echo T2-weighted fat-suppressed image (4,000/104) corresponding to A depicts hyperintense nonadipose soft-tissue nodules, thick septa, and fat-suppressed low-signal adipose components.

 


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Fig. 1C. 53-year-old man with spindle cell lipoma in subcutaneous adipose tissue of posterior neck. Photomicrograph of histopathologic specimen of spindle cell lipoma shows spindle cells (long straight arrow) throughout specimen, scattered vascular channels (curved arrow), and lipocytes (short straight arrow) in background of mucoid matrix. (H and E, x100)

 


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Fig. 2A. 69-year-old man with spindle cell lipoma in ischiorectal fossa. Axial unenhanced T1-weighted image (TR/TE, 690/15) shows well-defined mass (arrows). Note relatively equal distribution of adipose and nonadipose tissue, which is characteristic of spindle cell lipoma.

 


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Fig. 2B. 69-year-old man with spindle cell lipoma in ischiorectal fossa. Axial fast spin-echo T2-weighted image (6,498/130) shows mass (arrows) with similar distribution of adipose and nonadipose tissue. Nonadipose components show signal intensity greater than that of fat.

 


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Fig. 2C. 69-year-old man with spindle cell lipoma in ischiorectal fossa. Axial T1-weighted gadolinium-enhanced fat-suppressed image (450/15) shows intense enhancement of nonadipose components of tumor (arrows). High signal intensity in right ischium is due to nonuniform fat suppression.

 


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Fig. 2D. 69-year-old man with spindle cell lipoma in ischiorectal fossa. Axial contrast-enhanced CT image obtained through lower pelvis shows well-circumscribed ovoid mass (black arrows) that contains both adipose and markedly enhancing nonadipose tissue nodules. Thin septa (white arrow) are also identified in medial portion of mass.

 


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Fig. 3A. 48-year-old man with spindle cell lipoma in subcutaneous tissue of neck. Sagittal unenhanced T1-weighted image (TR/TE, 550/16) shows well-defined 2-cm mass (arrows) with signal intensity similar to that of muscle.

 


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Fig. 3B. 48-year-old man with spindle cell lipoma in subcutaneous tissue of neck. Sagittal fast spin-echo T2-weighted image (3,500/98) corresponding to A shows mass (arrows) to have signal intensity similar to that of fat.

 


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Fig. 3C. 48-year-old man with spindle cell lipoma in subcutaneous tissue of neck. Axial T1-weighted gadolinium-enhanced image (450/15) shows intense enhancement (arrows) after IV gadolinium administration.

 


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Fig. 4A. 43-year-old man with spindle cell lipoma in subcutaneous tissue of forearm. Unenhanced axial T1-weighted image (TR/TE, 400/14) shows 3-cm fatty mass (arrows) in subcutaneous fat.

 


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Fig. 4B. 43-year-old man with spindle cell lipoma in subcutaneous tissue of forearm. Axial fat-suppressed T2-weighted image (2,300/60) corresponding to A shows scattered thin septa within mass (arrows) and signal intensity slightly greater than that of adjacent adipose tissue.

 

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