Histologic Correlation With Magnetic Resonance Imaging for Benign and Malignant Lipomatous MassesReport as inadecuate




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Sarcoma - Volume 1 1997, Issue 3-4, Pages 175-179



Indiana University School of Medicine, Indianapolis, IN, USA

702 Barnhill Drive, Room 1134, Indianapolis 46202-5111, IN, USA



Copyright © 1997 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose-results. We evaluated the diagnostic accuracy of magnetic resonance imaging MRI for 46 consecutive patientswith lipomatous soft tissue tumors prior to biopsy and resection. Twenty-eight patients had benign lipomas and 18 hadliposarcomas. Clinical differences between thdse patients with benign disease and those with malignant lesions wereaverage age at the time of presentation 49 years for benign vs 62 years for malignant, p < 0.001 and average length ofsymptoms prior to resection 64 months for benign versus 38 months for malignant, p = 0.01. MRI characteristicsassociated with benign disease included: smaller tumor size 9.4 cm average greatest dimension for benign lesions vs13.4 cm for malignant masses, p = 0.022; a mass with a uniformly homogeneous signal p = 0.0003; a mass withhomogeneous high T1 and T2 signals and a low short-time-inversion-recovery STIR signal comparable to normal fatp < 0.0001. This last signal pattern was not seen in malignant lesions 0-18 and was present in almost all benign lipomas25-28. The usual MRI descriptions of soft tissue masses such as infiltrating vs encapsulating, deep vs subcutaneous andseptated vs non-septated were not helpful predictors of malignancy in this series. Needle biopsies of lipomatous masseswith heterogeneous signals on MRI resulted in inaccurate diagnoses due to sampling error in 5-9 patients.

Discussion. A carefully planned and performed MRI study of lipomatous masses can accurately predict a benign lipomawhenever a homogeneous high T1 and T2, as well as a low STIR, signal is present. However, a mass with any other signalcharacteristics must be biopsied carefully in order to make an accurate diagnosis.





Author: Bruce T. Rougraff, Mark Durbin, Jackie Lawerence, and Kenneth Buckwalter

Source: https://www.hindawi.com/



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