Pancreatic lipoma

Changed by Ammar Haouimi, 10 Dec 2018

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Pancreatic lipomas are uncommon mesenchymal tumors of the pancreas.

Clinical presentation

Rarely symptomatic, they are most often detected incidentally on cross-sectional imaging for another purpose. If they do cause symptoms, it will typically be those related to regional mass effect from the mass.

Pathology

Mature fat cells with thin internal fibrous septa. It differs from pancreatic lipomatosis in that it has well-defined margins conferred by a thin collagen capsule.

Radiographic features

Correct diagnosis is important to avoid confusion with a neoplastic process. Most contain macroscopic fat.

Ultrasound

difficult to diagnose: may be hyperechoic or hypoechoic

CT

well-circumscribed, lobulated lesion in the pancreas
generally fat attenuation (≤ -30 HU)
non-enhancing

MRI

well-circumscribed, lobulated lesion in the pancreas
T1 and T2 hyperintense
saturates on a fat-saturated sequence
may not be hypointense on an out-of-phase sequence (edge may show "india-ink" artefact)

Treatment and prognosis

They are benign lesions, and only rarely require resection.

Differential diagnosis

pancreatic mature cystic teratoma (dermoid): even more rare; may have associated calcifications
liposarcoma: should be considered if there are atypical findings such as an infiltrative lesion, a large lesion, or solid enhancing elements
focal fatty infiltration³

pseudohypertrophic lipomatosis ⁴

+<li>pseudohypertrophic lipomatosis 4
+</li>

References changed:

4. Bhatt S, Ahmad M, Tandon A, Mandal S, Garg D. Pancreatic Lipoma and Its Differentiation from Various Fat Containing Lesions in the Pancreas: An Imaging Guide. IJRRT. 2017;4(5):62-5. <a href="https://doi.org/10.15406/ijrrt.2017.04.00112">doi:10.15406/ijrrt.2017.04.00112</a>
4. Bhatt S, Ahmad M, Tandon A, Mandal S, Garg D. Pancreatic Lipoma and Its Differentiation from Various Fat Containing Lesions in the Pancreas: An Imaging Guide. IJRRT. 2017;4(5):62-5. <a href="https://doi.org/10.15406/ijrrt.2017.04.00112">doi:10.15406/ijrrt.2017.04.00112</a>
4. Bhatt S, Ahmad M, Tandon A, Mandal S, Garg D. Pancreatic Lipoma and Its Differentiation from Various Fat Containing Lesions in the Pancreas: An Imaging Guide. IJRRT. 2017;4(5):62-5. <a href="https://doi.org/10.15406/ijrrt.2017.04.00112">doi:10.15406/ijrrt.2017.04.00112</a>
4. M N Ahmad, M Husain, A A Wani,et al. Pancreatic Lipoma - A Case Report with Review of Literature. JOP. Journal of the Pancreas.
4. Mir Najib Ahmad, Musharraf Husain, Ajaz Ahmed Wani, Raja Nadeem, Prakhar Gupta, Shahbaz Alam, Mohammad Imran. Pancreatic Lipoma - A Case Report with Review of Literature. JOP. Journal of the Pancreas.

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