AJR Customized AJR reprints in quantities as low as 100!
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bui-Mansfield, L. T.
Right arrow Articles by Chew, F. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bui-Mansfield, L. T.
Right arrow Articles by Chew, F. S.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
AJR 2000; 174:1698
© American Roentgen Ray Society

Radiologic-Pathologic Conferences of Wake Forest University Baptist Medical Center

Parosteal Lipoma of the Fibula

Liem T. Bui-Mansfield1, Cris P. Myers2 and Felix S. Chew1

1 Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157-1088.
2 Department of Pathology, Walter Reed Army Medical Center, 6825 16th St. N.W., Washington, DC 20307-5001.

Received January 7, 2000; accepted after revision January 24, 2000.

 
The opinions and assertions contained herein are those of the authors and should not be construed as official or as representing the opinions of the Department of the Army or the Department of Defense.

Address correspondence to F. S. Chew.


Introduction
Top
 Introduction
References
 
A 28-year-old man had a painless proximal leg mass for one year. Radiography showed an exostotic bone lesion arising from the posterior cortex of the proximal fibular diaphysis, capped by fat lucency (Fig. 1A). CT and MR imaging showed a mass of mature bone arising from the cortical surface surrounded by fat (Figs. 1B and 1C). The marrow space of the fibula was not contiguous with that of the lesion. After resection, a whole-mount cross-section of the lesion showed a well-circumscribed cartilage-capped osseous proliferation attached to the fibular cortex with an overlying mass of adipose tissue (Fig. 1D). Microscopy showed no cellular atypia of any tissue element. The final pathologic diagnosis was parosteal lipoma.



View larger version (82K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1A. —28-year-old man with parosteal lipoma of right fibula. Radiograph of knee shows bone lesion mimicking sessile osteochondroma capped by zone of fat lucency (arrow).

 


View larger version (98K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1B. —28-year-old man with parosteal lipoma of right fibula. CT scan shows lipomatous mass (arrow) adhering to periosteum of bony mass. Note lack of marrow contiguity with underlying fibula.

 


View larger version (131K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1C. —28-year-old man with parosteal lipoma of right fibula. MR image shows fibrovascular strands within lipomatous mass.

 


View larger version (174K):
[in this window]
[in a new window]
[as a PowerPoint slide]
  		Fig. 1D. —28-year-old man with parosteal lipoma of right fibula. Photomicrograph of histopathologic resected specimen shows well-circumscribed pedunculated bony proliferation with overlying mass of mature adipose tissue (F). Marrow space of fibula (M) is separate from that of proliferative bone (B). (H and E, x20)

 

Parosteal lipoma is a rare benign tumor of adipose tissue that is situated directly on the cortex of bone [1]. Thought to arise from mesenchymal cells in the periosteum, parosteal lipomas share histopathologic features with the commonly occurring soft-tissue lipomas, and cytogenetic evidence suggests a common histopathogenesis [2]. Depending on the degree of chondroid modulation and enchondral ossification, parosteal lipomas may rest directly on the cortex without cartilage or bone elements; may have a narrow bony stalk with a lucent lipomatous cap, mimicking a pedunculated exostosis; may have a densely ossified broad-based osteochondromatous element beneath a thin lipomatous cap, simulating a sessile exostosis; or may have patches of chondroid and bone scattered throughout the lipomatous mass [1].

On radiographs, a parosteal lipoma is a well-defined area of lucency located adjacent to a long bone (Fig. 1A). In one series of parosteal lipomas [3], 60% had definite bony alterations, mostly hyperostotic reactive changes (fine linear densities, calcification, cortical thickening or undulation, or frank excrescences of bone), but these lipomas also have cortical bowing and smooth cortical erosions. Bone destruction was consistently absent. On CT and MR imaging [4], parosteal lipomas have a homogeneous lobulated appearance and are adherent to the surface of the adjacent bone. When present, osseous excrescences may mimic osteochondromas, but the former lack the contiguity of the marrow space with the underlying bone that is characteristic of the latter. MR imaging may show low-signal-intensity strands in the lesion, corresponding to fibrovascular strands that are commonly found in lipomatous lesions. Parosteal lipomas that gain clinical attention are frequently situated so that they compress neurovascular bundles and cause motor and sensory function deficits. Common sites of involvement include the proximal forearm and the sciatic nerve [3].

Parosteal lipomas are treated surgically; no malignant potential has been reported.


References
Top
 Introduction
 References
 

  1. Miller MD, Ragsdale BD, Sweet DE. Parosteal lipoma: a new perspective. Pathology 1992;24:132 -139[Medline]
  2. Petit MM, Swarts S, Bridge JA, Van de Ven WJ. Expression of reciprocal fusion transcripts of the HMGIC and LPP genes in parosteal lipoma. Cancer Genet Cytogenet 1998;106:18 -23[Medline]
  3. Fleming RJ, Alpert M, Garcia A. Parosteal lipoma. AJR 1962;87:1075 -1084
  4. Murphey MD, Johnson DL, Bhatia PS, Neff JR, Rosenthal HG, Walker CW. Parosteal lipoma: MR imaging characteristics. AJR 1994;162:105 -110[Abstract/Free Full Text]

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
S.-M. Jang, W. Na, Y. J. Jun, W. S. Chung, and S. S. Paik
Parosteal Lipoma of the Rib
Ann. Thorac. Surg., January 1, 2009; 87(1): 316 - 318.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
J. D. Pitcher Jr and F. S. Chew
Possible Duplicate Publication: AJR 2000;174:1698 and Clin Orthop 2000;373:311-316, 318-319
Am. J. Roentgenol., April 1, 2001; 176 (4): 1078 - 1079.
[Full Text] [PDF]

This Article
Right arrow Figures Only
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bui-Mansfield, L. T.
Right arrow Articles by Chew, F. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bui-Mansfield, L. T.
Right arrow Articles by Chew, F. S.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS