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Combined classical spindle cell/pleomorphic lipoma spectrum imaging and clinical data

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Abstract

Objectives

Compile the largest study to date on the imaging and clinical features of the classic spindle cell/pleomorphic lipoma spectrum and suggest this diagnosis be included in the differential for benign and malignant macroscopic fat-containing soft tissue masses regardless of the mass location or patient demographics.

Materials and methods

An institutional search was performed to identify all available classic-type spindle cell/pleomorphic lipomas with available demographic and imaging data. Images and reports were analyzed by one MSK-trained radiologist and radiographic, anatomic and clinical data were recorded. Additionally, a literature search was performed to identify studies describing the spindle cell lipoma spectrum imaging features and were combined with institutional data.

Results

Forty-two institutional cases were identified, 37 of which had MRIs performed among which 21 had images available (T1- and T2-weighted pulse sequences) for review while the remainder had outside reports detailing the mass imaging features. There was a mean age of 57 with 79% of cases occurring in males. Contrary to prior reports, 57% of masses were subcutaneous, and the neck and back region accounted for 26% of cases. When the institutional cases were combined with available data in the literature, there was a new sample size of 91 masses, 74 of which had MRI and/or CT data. Eighty-seven percent of masses were heterogeneous, 51% were composed of less than 75% fat, 65% were in the back, neck or shoulder region, 27% of masses were deep and 91% demonstrated enhancement. Eighty-two percent of patients were males with a mean age of 58 at excision.

Conclusion

Imaging features, patient demographics and tumor location alone are not enough to differentiate tumors of the spindle cell lipoma spectrum from other macroscopic fat-containing benign and malignant tumors, and these entities should be included in the same imaging differential diagnosis.

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References

  1. Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology. 2002;224(1):99–104.

    Article  PubMed  Google Scholar 

  2. Choi JW, Kim HJ, Kim J, Kim HJ, Cha JH, Kim ST. Spindle cell lipoma of the head and neck: CT and MR imaging findings. Neuroradiology. 2013;55(1):101–6.

    Article  PubMed  Google Scholar 

  3. Kirwadi A, Abdul-Halim R, Fernando M, Highland A, Kotnis N. MR imaging features of spindle cell lipoma. Skelet Radiol. 2014;43(2):191–6.

    Article  Google Scholar 

  4. Bancroft L, Kransdorf MJ, Peterson JJ, Sundaram M, Murphey MD, O'Connor MI. Imaging characteristics of spindle cell lipoma. AJR Am J Roentgenol. 2003;181(5):1251–4.

    Article  PubMed  Google Scholar 

  5. Khashper A, Zheng J, Nahal A, Discepola F. Imaging characteristics of spindle cell lipoma and its variants. Skelet Radiol. 2014;43(5):591–7.

    Article  Google Scholar 

  6. Panagopoulos I, Gorunova L, Bjerkehagen B, Andersen K, Lund-Iversen M, Heim S. Loss of chromosome 13 material in cellular angiofibromas indicates pathogenetic similarity with spindle cell lipomas. Diagn Pathol. 2017;12(1):17.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ntorkou AA, Tsili AC, Giannakis D, Batistatou A, Stavrou S, Sofikitis N, et al. Magnetic resonance imaging findings of cellular angiofibroma of the tunica vaginalis of the testis: a case report. J Med Case Rep. 2016;10:71.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shintaku M, Naitou M, Nakashima Y. Angiomyofibroblastoma-like tumor (lipomatous variant) of the inguinal region of a male patient. Pathol Int. 2002;52(9):619–22.

    Article  PubMed  Google Scholar 

  9. Brisson M, Kashima T, Delaney D, Tirabosco R, Clarke A, Cro S, et al. MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification. Skelet Radiol. 2013;42(5):635–47.

    Article  Google Scholar 

  10. Rizer M, Singer AD, Edgar M, Jose J, Subhawong TK. The histological variants of liposarcoma: predictive MRI findings with prognostic implications, management, follow-up, and differential diagnosis. Skelet Radiol. 2016;45(9):1193–204.

    Article  Google Scholar 

  11. Clay MR, Martinez AP, Weiss SW, Edgar MA. MDM2 amplification in problematic Lipomatous tumors: analysis of FISH testing criteria. Am J Surg Pathol. 2015;39(10):1433–9.

    Article  PubMed  Google Scholar 

  12. Mariño-Enriquez A, Nascimento AF, Ligon AH, Liang C, Fletcher CD. Atypical spindle cell Lipomatous tumor: Clinicopathologic characterization of 232 cases demonstrating a morphologic Spectrum. Am J Surg Pathol. 2017;41(2):234–44.

    Article  PubMed  Google Scholar 

  13. Deyrup AT, Chibon F, Guillou L, Lagarde P, Coindre JM, Weiss SW. Fibrosarcoma-like lipomatous neoplasm: a reappraisal of so-called spindle cell liposarcoma defining a unique lipomatous tumor unrelated to other liposarcomas. Am J Surg Pathol. 2013;37(9):1373–8.

    Article  PubMed  Google Scholar 

  14. Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. WHO classification of tumours of soft tissue and bone. Pathology and genetics of tumours of soft tissue and bone. 4th ed. Lyon: IARC Press; 2013.

  15. Weiss SW, Rao VK. Well-differentiated liposarcoma (atypical lipoma) of deep soft tissue of the extremities, retroperitoneum, and miscellaneous sites. A follow-up study of 92 cases with analysis of the incidence of “dedifferentiation”. Am J Surg Pathol. 1992;16(11):1051–8.

    Article  CAS  PubMed  Google Scholar 

  16. Lucas DR, Nascimento AG, Sanjay BK, Rock MG. Well-differentiated liposarcoma. The Mayo Clinic experience with 58 cases. Am J Clin Pathol. 1994;102(5):677–83.

    Article  CAS  PubMed  Google Scholar 

  17. Zhang H, Erickson-Johnson M, Wang X, Oliveira JL, Nascimento AG, et al. Molecular testing for lipomatous tumors: critical analysis and test recommendations based on the analysis of 405 extremity-based tumors. Am J Surg Pathol. 2010;34(9):1304–11.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology and Imaging Sciences Section of Musculoskeletal Imaging, Emory University Hospital, 59 Executive Park South, 4th Floor Suite 4009, Atlanta, GA, 30329, USA

    Yara Younan, Felix Gonzalez, Monica Umpierrez & Adam D. Singer

  2. Department of Pathology, Emory University Hospital, Atlanta, GA, USA

    Anthony Martinez & Mark Edgar

  3. Department of Orthopedic Surgery, Emory University Hospital, Atlanta, GA, USA

    Nickolas Reimer

  4. Department of Radiology, University of Miami, Miami, FL, USA

    Ty Subhawong

Authors
  1. Yara Younan
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  2. Anthony Martinez
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  3. Nickolas Reimer
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  4. Mark Edgar
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  5. Felix Gonzalez
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  6. Monica Umpierrez
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  7. Ty Subhawong
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  8. Adam D. Singer
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Contributions

Guarantors of the integrity of the entire study, all authors; study concepts/study design or data acquisition or data analysis/interpretation, Y.Y., A.M., M.E., M.U., F.G., T.K.S, A.D.S.; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agree to ensure any questions related to the work are appropriately resolved, all authors; literature research, Y.Y., A.M., M.E., A.D.S.; clinical studies, N.R., M.E., A.M., M.U.; statistical analysis, Y.Y., T.K.S, A.D.S.; manuscript editing, all authors.

Corresponding author

Correspondence to Adam D. Singer.

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The authors have no relevant conflicts to disclose.

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Approved by the IRB with waiver of informed consent.

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Younan, Y., Martinez, A., Reimer, N. et al. Combined classical spindle cell/pleomorphic lipoma spectrum imaging and clinical data. Skeletal Radiol 47, 51–59 (2018). https://doi.org/10.1007/s00256-017-2751-1

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  • DOI: https://doi.org/10.1007/s00256-017-2751-1

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