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| {| class="wikitable"
| | [[Syncope]] is classified into three types: |
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| | * [[Cardiac]] |
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| | * [[Neurogenic]] |
| | align="center" style="background:#4479BA; color: #FFFFFF;" |Location
| | * [[Vasovagal syncope|vasovagal]] |
| | align="center" style="background:#4479BA; color: #FFFFFF;" |'''Diagnostic Modality'''
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| | align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnostic Value
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| | rowspan="4" align="center" style="background:#f0f0f0;" |Ascending Aortic Dissection
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| * Transthoracic Echocardiography
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| * Transoesophageal Echocardiography
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| | rowspan="4" align="center" style="background:#f0f0f0;" |Aortic Arch Dissection
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| | rowspan="4" align="center" style="background:#f0f0f0;" |Descending Aortic Dissection
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Lipomatous tumor}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Age of onset}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Gender preponderance}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Location}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Clinical features}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Pathologic appearance}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Other features}}
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| ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Pathologic view}}
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Angiolipoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Second and third decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female < male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly seen in forearm
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| * May also affect trunk and upper arm
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Subcutaneous nodule
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| * Tender to palpation
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| * Less than 2 cm
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Encapsulated, yellow nodules with a reddish tinge
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| * A combination of fatty tissue and vascular channels
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| * Fibrin thrombi is present in vascular channels (characteristic finding)
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Benign
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Capture1.PNG|thumb|none|200px|Contributed by Dr. Dharam Ramnani in Webpathology]]
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Myolipoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Fifth and sixth decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female > male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly seen in retroperitoneum, abdomen, pelvis, inguinal region, or abdominal wall
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| * May also affect extremities
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Subcutaneous mass which may also engage superficial muscular fascia
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| * Size differs depending on the location
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Partially encapsulated mass with partially yellow-white cut surface
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| * A combination of mature adipocytes and sheets of well-differentiated smooth muscle
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| * No nuclear atypia
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| *Sieve-like appearance at low magnification (due to interspersed location of smooth muscle component)
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Benign
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| * It is usually large and located in the deep soft tissues
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Capture.PNG|thumb|none|200px|Contributed by Dr. Dharam Ramnani in Webpathology]]
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Myelolipoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Fifth decade of life | |
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female = male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly seen in adrenal glands
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| * Other possible locations include:
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| * thoracic, retroperitoneum and presacral region, mediastinum, liver, and bone
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Usually asymptomatic
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| * May cause abdominal pain, nausea, and constipation (depending on the location and size)
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| * Uncommonly, may cause retro-peritoneal hemorrhage
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| * 3 to 7 cm
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * A combination of bone marrow elements and adipose tissue in varying proportions
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| * May show myxoid changes
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Well-circumscribed radiolucent mass in radiologic imaging
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| * May have hromonal activity
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Adrenal Myelolipoma MP CTR.jpg|thumb|none|200px|Contributed by Sarahkayb in Wikimedia commons]]
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Spindle Cell/Pleomorphic Lipoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Fifth to seventh decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female < male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly seen in posterior neck, shoulder, and back
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| * It is also reported in oral cavity
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Subcutaneous nodule with firm consistency
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| * Slowly growing and painless
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| * Mostly between 3 to 5 cm
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Similar to ordinary lipoma
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| * A combination of mature fat cells and spindle cell or pleomorphic elements
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| * Lipomatous component may vary in amount
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Immunohistochemically positive for CD34 | |
| * Benign
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Spindle cell lipoma -- intermed mag.jpg|thumb|none|200px|Contributed by Nephron in Wikimedia commons]]
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| !style="padding: 5px 5px; background: #DCDCDC; " align="left" |Chondroid Lipoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Third or fourth decade of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female > male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * More commonly seen in limbs and limb girdles
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| * May also involve trunk, and the head and neck region, particularly the oral cavity
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Slowly growing painless mass
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| * Sizes ranges from 1 to 11 cm
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Encapsulated tumor with a yellow, white, or pink-tan cut surface
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| * A combination of mature adipocytes in association with nests of vacuolated cells in a myxochondroid or hyalinized fibrous background
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Heterogeneous soft tissue mass in radiologic imaging
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| * Benign
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Capture2.PNG|thumb|none|200px|Contributed by Dr. Dharam Ramnani in Webpathology]]
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| !style="padding: 5px 5px; background: #DCDCDC; " align="left" |Hibernoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Third decade of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female = male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Most commonly seen in thigh
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| * May also affect shoulder, back, neck, chest, arm, and abdominal cavity/retroperitoneum
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Slowly growing, painless, subcutaneous mass
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| * Affects intramuscular in 10% of the cases
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| *Size varies between 5 to 15 cm
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| *
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Well-defined, soft, and mobile mass
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| * A combination of vacuolated granular eosinophilic cells with abundant mithochondria and high vascular content
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| *
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Immunohistochemically positive for S-100
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| * Benign
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Hibernoma2.jpg|thumb|none|200px|Contributed by Nephron in Wikimedia commons]]
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left"|Intramuscular and Intermuscular Lipomas
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Fourth to seventh decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female < male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Most commonly seen in large muscles of the extremities, especially in thigh, shoulder, and upper arm | |
| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Painless, slowly growing mass
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| * Visible during muscle contraction
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Infiltrative adipose thissue within the muscle
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| * Absence of nuclear atypia
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * May be very small or more than 20 cm
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[File:Capture3.PNG|thumb|none|200px|Contributed by Dr. Dharam Ramnani in Webpathology]]
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left" |Lipomas of Tendon Sheaths and Joints
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Second and third decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female = male
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| * Lipoma of joints affects men more frequently than women
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Most commonly seen in wrist and hand
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| * May also affect ankle and foot
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| * Bilateral and symmetric location in 50% of the cases
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * May cause severe pain, trigger finger, or even symptoms of carpal tunnel syndrome
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * May have 2 different shape:
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| * A single adipose tissue extending along the tendon sheet
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| * A lipomatous lesion composed mostly from hypertrophic synovial villi
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Radiologic imaging may show a lesion of less density than the surrounding tissue
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| |style="padding: 5px 5px; background: #F5F5F5;" align="left" |_
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left"|Lumbosacral Lipoma
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * First decade of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female > male
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * It occurs in the lumbosacral region and overlies the spine
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Initially, asymptomatic
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| * Later signs and symptoms of progressive myelopathy or radiculopathy in the lower legs, bladder, or bowel
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Uncapsulated mass that consists of lobulated adipose tissue
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| * Vascular proliferation and smooth muscle tissue may be present
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Almost always associated with spina bifida or a similar laminar defect (lipomyeloschisis)
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |_
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| ! style="padding: 5px 5px; background: #DCDCDC; " align="left"|Neural Fibrolipoma (Lipofibromatous Hamartoma of Nerves)
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * First three decades of life
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Female > male (in the presence of macrodactyly)
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Most commonly affect median nerve and its branches
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| * May also affect ulnar, radial, peroneal, and cranial nerves
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * May cause neuropathy, pain, paresthesia, and decreased sensation
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| * Carpal tunnel syndrome may also occur
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * A sausage-shaped mass with soft teture that has diffusely infiltrated a large nerve and its branches
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| * Fibrofatty tissue surronding and infiltrating the nerve trunk
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
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| * Overgrowth of bone and macrodactyly of the digits innervated by the affected nerve is seen in one third of the cases
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| | style="padding: 5px 5px; background: #F5F5F5;" align="left" |_
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| |}
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| ===Example #1===
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| The patient presented with S.O.B. one year after hysterectomy for a leiomyomatous uterus.
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Intravascular-extension-leiomyoma-001.jpg|CT in Intravenous leiomyomatosis
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| Image:Intravascular-extension-leiomyoma-002.jpg
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Intravascular-extension-leiomyoma-003.jpg
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| Image:Intravascular-extension-leiomyoma-004.jpg
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Intravascular-extension-leiomyoma-005.jpg
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| Image:Intravascular-extension-leiomyoma-006.jpg
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Intravascular-extension-leiomyoma-007.jpg
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| Image:Intravascular-extension-leiomyoma-008.jpg
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| </gallery>
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| </div>
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| <references />
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