Imaging of spindle cell lipoma

Area of Science:

• Radiology
• Oncology
• Pathology

Background:

• Spindle cell lipoma (SCL) is a benign soft tissue tumor.
• Accurate diagnosis is crucial to differentiate from malignant neoplasms.
• Imaging plays a key role in the evaluation of SCLs.

Purpose of the Study:

• To review the evaluation, diagnosis, and treatment of spindle cell lipoma (SCL).
• To emphasize the location of SCLs and their spectrum of MRI and CT appearances.
• To aid in differentiating SCLs from other soft tissue tumors.

Main Methods:

• Retrospective evaluation of MRI and CT findings in 27 histopathologically proven SCLs.
• Analysis of imaging features including margins, fat content, signal characteristics, edema, and contrast enhancement.
• Correlation of imaging findings with patient demographics and tumor characteristics.

Main Results:

• SCLs exhibited variable imaging appearances, with 19% showing no visible fat and 19% having less than 50% fat.
• Only 12% of lesions appeared as typical lipomas on unenhanced MRI.
• All contrast-enhanced SCLs showed enhancement, with 44% demonstrating marked enhancement.

Conclusions:

• Spindle cell lipomas can have variable imaging features, including minimal or absent fat on MRI/CT.
• Imaging characteristics may pose challenges in distinguishing SCLs from higher-grade malignant tumors.
• Understanding the imaging spectrum of SCLs is essential for accurate diagnosis.