Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis
The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is eas...
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| Vydané v: | Radiographics Ročník 36; číslo 3; s. 710 - 734 |
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| Hlavní autori: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
01.05.2016
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| ISSN: | 1527-1323 |
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| Abstract | The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is easily recognized because of its characteristic imaging appearance. It typically is hyperechoic at ultrasonography and demonstrates low attenuation at computed tomography (-10 to -100 HU). Magnetic resonance imaging is a more ideal imaging modality because it has better soft-tissue image contrast and higher sensitivity for depicting (a) microscopic fat by using chemical shift imaging and (b) macroscopic fat by using fat-suppression techniques. Whether a lesion arises from a retroperitoneal organ or from the soft tissues of the retroperitoneal space (primary lesion) is determined by examining the relationship between the lesion and its surrounding structures. Multiple imaging signs help to determine the organ of origin, including the "beak sign," the "embedded organ sign," the "phantom (invisible) organ sign," and the "prominent feeding artery sign." Adrenal adenoma is the most common adrenal mass that contains microscopic fat, while myelolipoma is the most common adrenal mass that contains macroscopic fat. Other adrenal masses, such as pheochromocytoma and adrenocortical carcinoma, rarely contain fat. Renal angiomyolipoma is the most common fat-containing renal mass. Other fat-containing renal lesions, such as lipoma and liposarcoma, are rare. Fatty replacement of the pancreas and pancreatic lipomas are relatively common, whereas pancreatic teratomas are rare. Of the primary retroperitoneal fat-containing lesions, lipoma and liposarcoma are common, while other lesions are relatively rare. (©)RSNA, 2016. |
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| AbstractList | The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is easily recognized because of its characteristic imaging appearance. It typically is hyperechoic at ultrasonography and demonstrates low attenuation at computed tomography (-10 to -100 HU). Magnetic resonance imaging is a more ideal imaging modality because it has better soft-tissue image contrast and higher sensitivity for depicting (a) microscopic fat by using chemical shift imaging and (b) macroscopic fat by using fat-suppression techniques. Whether a lesion arises from a retroperitoneal organ or from the soft tissues of the retroperitoneal space (primary lesion) is determined by examining the relationship between the lesion and its surrounding structures. Multiple imaging signs help to determine the organ of origin, including the "beak sign," the "embedded organ sign," the "phantom (invisible) organ sign," and the "prominent feeding artery sign." Adrenal adenoma is the most common adrenal mass that contains microscopic fat, while myelolipoma is the most common adrenal mass that contains macroscopic fat. Other adrenal masses, such as pheochromocytoma and adrenocortical carcinoma, rarely contain fat. Renal angiomyolipoma is the most common fat-containing renal mass. Other fat-containing renal lesions, such as lipoma and liposarcoma, are rare. Fatty replacement of the pancreas and pancreatic lipomas are relatively common, whereas pancreatic teratomas are rare. Of the primary retroperitoneal fat-containing lesions, lipoma and liposarcoma are common, while other lesions are relatively rare. (©)RSNA, 2016. |
| Author | Rezvani, Maryam Elsayes, Khaled M Menias, Christine O Tubay, Marc Woodward, Paula J Shaaban, Akram M |
| Author_xml | – sequence: 1 givenname: Akram M surname: Shaaban fullname: Shaaban, Akram M organization: From the Department of Radiology, University of Utah, 30 North 1900 East, 1A71, Salt Lake City, UT 84132 (A.M.S., M.R., P.J.W.); Imaging Department, U.S. Air Force Academy Medical Clinic, USAF Academy, Colorado Springs, Colo (M.T.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.) – sequence: 2 givenname: Maryam surname: Rezvani fullname: Rezvani, Maryam organization: From the Department of Radiology, University of Utah, 30 North 1900 East, 1A71, Salt Lake City, UT 84132 (A.M.S., M.R., P.J.W.); Imaging Department, U.S. Air Force Academy Medical Clinic, USAF Academy, Colorado Springs, Colo (M.T.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.) – sequence: 3 givenname: Marc surname: Tubay fullname: Tubay, Marc organization: From the Department of Radiology, University of Utah, 30 North 1900 East, 1A71, Salt Lake City, UT 84132 (A.M.S., M.R., P.J.W.); Imaging Department, U.S. Air Force Academy Medical Clinic, USAF Academy, Colorado Springs, Colo (M.T.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.) – sequence: 4 givenname: Khaled M surname: Elsayes fullname: Elsayes, Khaled M organization: From the Department of Radiology, University of Utah, 30 North 1900 East, 1A71, Salt Lake City, UT 84132 (A.M.S., M.R., P.J.W.); Imaging Department, U.S. Air Force Academy Medical Clinic, USAF Academy, Colorado Springs, Colo (M.T.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.) – sequence: 5 givenname: Paula J surname: Woodward fullname: Woodward, Paula J organization: From the Department of Radiology, University of Utah, 30 North 1900 East, 1A71, Salt Lake City, UT 84132 (A.M.S., M.R., P.J.W.); Imaging Department, U.S. Air Force Academy Medical Clinic, USAF Academy, Colorado Springs, Colo (M.T.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.) – sequence: 6 givenname: Christine O surname: Menias fullname: Menias, Christine O organization: From the Department of Radiology, University of Utah, 30 North 1900 East, 1A71, Salt Lake City, UT 84132 (A.M.S., M.R., P.J.W.); Imaging Department, U.S. Air Force Academy Medical Clinic, USAF Academy, Colorado Springs, Colo (M.T.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E.); and Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.) |
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| SubjectTerms | Diagnosis, Differential Diagnostic Imaging Humans Intra-Abdominal Fat - diagnostic imaging Intra-Abdominal Fat - pathology Lipomatosis - diagnosis Lipomatosis - pathology Retroperitoneal Space - diagnostic imaging Retroperitoneal Space - pathology |
| Title | Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis |
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