Sandbox:Sahar

Location	Diagnostic Modality	Diagnostic Value
Ascending Aortic Dissection	Transthoracic Echocardiography	Moderate
	Transoesophageal Echocardiography	Excellent
	CT Scan	Excellent
	MRI	Excellent
Aortic Arch Dissection	Transthoracic Echocardiography	Poor
	Transoesophageal Echocardiography	Poor
	CT Scan	Excellent
	MRI	Excellent
Descending Aortic Dissection	Transthoracic Echocardiography	Poor
	Transoesophageal Echocardiography	Excellent
	CT Scan	Excellent
	MRI	Excellent

Lipomatous tumor	Age of onset	Gender preponderance	Location	Clinical features	Pathologic appearance	Other features	Pathologic view
Angiolipoma	Second and third decades of life	Female < male	More commonly seen in forearm May also affect trunk and upper arm	Subcutaneous nodule Tender to palpation Less than 2 cm	Encapsulated, yellow nodules with a reddish tinge A combination of fatty tissue and vascular channels Fibrin thrombi is present in vascular channels (characteristic finding)	Benign	Contributed by Dr. Dharam Ramnani in Webpathology
Myolipoma	Fifth and sixth decades of life	Female > male	More commonly seen in retroperitoneum, abdomen, pelvis, inguinal region, or abdominal wall May also affect extremities	Subcutaneous mass which may also engage superficial muscular fascia Size differs depending on the location	Partially encapsulated mass with partially yellow-white cut surface A combination of mature adipocytes and sheets of well-differentiated smooth muscle No nuclear atypia Sieve-like appearance at low magnification (due to interspersed location of smooth muscle component)	Benign It is usually large and located in the deep soft tissues	Contributed by Dr. Dharam Ramnani in Webpathology
Myelolipoma	Fifth decade of life	Female = male	More commonly seen in adrenal glands Other possible locations include: thoracic,  retroperitoneum  and presacral region,  mediastinum,  liver,  and bone	Usually asymptomatic May cause abdominal pain, nausea, and constipation (depending on the location and size) Uncommonly, may cause retro-peritoneal hemorrhage 3 to 7 cm	A combination of bone marrow elements and adipose tissue in varying proportions May show myxoid changes	Well-circumscribed radiolucent mass in radiologic imaging May have hromonal activity	Contributed by Sarahkayb in Wikimedia commons
Spindle Cell/Pleomorphic Lipoma	Fifth to seventh decades of life	Female < male	More commonly seen in posterior neck, shoulder, and back It is also reported in oral cavity	Subcutaneous nodule with firm consistency Slowly growing and painless Mostly between 3 to 5 cm	Similar to ordinary lipoma A combination of mature fat cells and spindle cell or pleomorphic elements Lipomatous component may vary in amount	Immunohistochemically positive for CD34 Benign	Contributed by Nephron in Wikimedia commons
Chondroid Lipoma	Third or fourth decade of life	Female > male	More commonly seen in limbs and limb girdles May also involve trunk, and the head and neck region, particularly the oral cavity	Slowly growing painless mass Sizes ranges from 1 to 11 cm	Encapsulated tumor with a yellow, white, or pink-tan cut surface A combination of mature adipocytes in association with nests of vacuolated cells in a myxochondroid or hyalinized fibrous background	Heterogeneous soft tissue mass in radiologic imaging Benign	Contributed by Dr. Dharam Ramnani in Webpathology
Hibernoma	Third decade of life	Female = male	Most commonly seen in thigh May also affect shoulder, back, neck, chest, arm, and abdominal cavity/retroperitoneum	Slowly growing, painless, subcutaneous mass Affects intramuscular in 10% of the cases Size varies between 5 to 15 cm	Well-defined, soft, and mobile mass A combination of vacuolated granular eosinophilic cells with abundant mithochondria and high vascular content	Immunohistochemically positive for S-100 Benign	Contributed by Nephron in Wikimedia commons
Intramuscular and Intermuscular Lipomas	Fourth to seventh decades of life	Female < male	Most commonly seen in large muscles of the extremities, especially in thigh, shoulder, and upper arm	Painless, slowly growing mass Visible during muscle contraction	Infiltrative adipose thissue within the muscle Absence of nuclear atypia	May be very small or more than 20 cm	Contributed by Dr. Dharam Ramnani in Webpathology
Lipomas of Tendon Sheaths and Joints	Second and third decades of life	Female = male Lipoma of joints affects men more frequently than women	Most commonly seen in wrist and hand May also affect ankle and foot Bilateral and symmetric location in 50% of the cases	May cause severe pain, trigger finger, or even symptoms of carpal tunnel syndrome	May have 2 different shape: A single adipose tissue extending along the tendon sheet A lipomatous lesion composed mostly from hypertrophic synovial villi	Radiologic imaging may show a lesion of less density than the surrounding tissue	_
Lumbosacral Lipoma	First decade of life	Female > male	It occurs in the lumbosacral region and overlies the spine	Initially, asymptomatic Later signs and symptoms of progressive myelopathy or radiculopathy in the lower legs, bladder, or bowel	Uncapsulated mass that consists of lobulated adipose tissue Vascular proliferation and smooth muscle tissue may be present	Almost always associated with spina bifida or a similar laminar defect (lipomyeloschisis)	_
Neural Fibrolipoma (Lipofibromatous Hamartoma of Nerves)	First three decades of life	Female > male (in the presence of macrodactyly)	Most commonly affect median nerve and its branches May also affect ulnar, radial, peroneal, and cranial nerves	May cause neuropathy, pain, paresthesia, and decreased sensation Carpal tunnel syndrome may also occur	A sausage-shaped mass with soft teture that has diffusely infiltrated a large nerve and its branches Fibrofatty tissue surronding and infiltrating the nerve trunk	Overgrowth of bone and macrodactyly of the digits innervated by the affected nerve is seen in one third of the cases	_

Example #1

The patient presented with S.O.B. one year after hysterectomy for a leiomyomatous uterus.

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  CT in Intravenous leiomyomatosis

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