Case Of the Week (COW) 14 Dec 2014
Answer:
Gaint omental and mesentric lipoma.
Findings:
Huge fat density (-50 to -100 H) lesion occupying whole of the abdomen extending from just beneath the diaphragm to the pelvis. retroperitoneal structures were displaced posteriorly and the bowel loops towards the periphery. Thin fibrous septations were also noted within the lesion. Vessels are traversing throgh the lesion.
Discussion:
Lipoma of the abdominal cavity, a benign neoplasm of mature fat cells usually presents as an asymptomatic abdominal mass or progressive abdominal distension. Lipomas are sometimes detected incidentally as an intraperitoneal radiolucent fat density mass . Lesions with predominantly microscopic fat include adrenal adenoma and some teratomas. Macroscopic fat can be identified with both CT and MRI. Identification of fat with CT is based on the attenuation (less than -20 HU). Several MRI techniques are used for fat suppression like spectroscopic fat saturation and chemical shift (in-phase/opposed-phase) imaging. Lesions with predominantly macroscopic fat include teratoma, myelolipoma, angiomyolipoma, liposarcoma, lipoma, epiploic appendagitis and omental infarction. In case of omental tumours, CT determines the omental origin of the tumour and also depicts the precise anatomical features.
Contributed By:
Dr. Balaji Ayyamperumal
Tanjore medical college
Answer:
Gaint omental and mesentric lipoma.
Findings:
Huge fat density (-50 to -100 H) lesion occupying whole of the abdomen extending from just beneath the diaphragm to the pelvis. retroperitoneal structures were displaced posteriorly and the bowel loops towards the periphery. Thin fibrous septations were also noted within the lesion. Vessels are traversing throgh the lesion.
Discussion:
Lipoma of the abdominal cavity, a benign neoplasm of mature fat cells usually presents as an asymptomatic abdominal mass or progressive abdominal distension. Lipomas are sometimes detected incidentally as an intraperitoneal radiolucent fat density mass . Lesions with predominantly microscopic fat include adrenal adenoma and some teratomas. Macroscopic fat can be identified with both CT and MRI. Identification of fat with CT is based on the attenuation (less than -20 HU). Several MRI techniques are used for fat suppression like spectroscopic fat saturation and chemical shift (in-phase/opposed-phase) imaging. Lesions with predominantly macroscopic fat include teratoma, myelolipoma, angiomyolipoma, liposarcoma, lipoma, epiploic appendagitis and omental infarction. In case of omental tumours, CT determines the omental origin of the tumour and also depicts the precise anatomical features.
Contributed By:
Dr. Balaji Ayyamperumal
Tanjore medical college