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Colonic lipomas revisited on CT colonography

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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

CT colonography (CTC) is growing in its utilization as a nationally approved colorectal cancer screening test. After colonic polyps, lipomas are the second most common colonic lesions and their accurate and rapid recognition are important.

Methods

This retrospective Institutional Review Board approved study was performed at two large academic university-based institutions. 1044 patients underwent CTC at Institution A from 2010 to 2018 and 1094 patients underwent CTC at Institution B from 2003 to 2015. All CTC examinations with at least one colonic lipoma in their report were evaluated by a fellowship-trained abdominal imaging radiologist. 47 CTC examinations containing 59 colonic lipomas were detected and included. Segmental location, sessile versus pedunculated morphology, multiplicity, average attenuation, and largest lesion diameter were evaluated. A review of the current literature on colonic lipomas is entailed.

Results

The overall incidence of colonic lipoma was 2.2% in women and 2.3% in men. Mean age for detection of colonic lipomas on CTC was 66.9 years. Segmental locations of colonic lipomas include ascending colon (39%), transverse colon (19%), ileocecal valve (12%), cecum (12%), descending colon (10%), and rectosigmoid (8%). 9% of colonic lipomas were multiple, 42% were pedunculated, and 58% were sessile. The mean (range) size of detected lipomas was 19 (6–59) mm. The mean (range) attenuation was − 132 (− 41 to − 258) HU.

Conclusion

Most colonic lipomas are located in the ascending colon. Although they are typically solitary, just under 10% are multiple, and although they are most often sessile, slightly under half are pedunculated mimicking polyps. CTC detects smaller lipomas than optical colonoscopy.

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Authors and Affiliations

  1. Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA

    Shima Roknsharifi

  2. Department of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA

    Zina Ricci, Mariya Kobi & Judy Yee

  3. Department of Radiology, University of California San Francisco, San Francisco, CA, USA

    Eugene Huo

Authors
  1. Shima Roknsharifi
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  2. Zina Ricci
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  3. Mariya Kobi
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  4. Eugene Huo
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  5. Judy Yee
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Contributions

All authors actively participated in the study and reviewed the paper.

Corresponding author

Correspondence to Zina Ricci.

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Conflict of interest

Shima Roknsharifi, Zina Ricci, Mariya Kobi, and Eugene Huo: None. Judy Yee: GE Healthcare, Philips.

Ethics approval

This study was approved by institutional review board (IRB) (IRB #2018-9582).

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Roknsharifi, S., Ricci, Z., Kobi, M. et al. Colonic lipomas revisited on CT colonography. Abdom Radiol 47, 1788–1797 (2022). https://doi.org/10.1007/s00261-022-03489-2

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  • DOI: https://doi.org/10.1007/s00261-022-03489-2

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