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Abdomen » Hepatobiliary
Hepatic Lipomas
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Author(s) :
Danilo Sirigu, MD
 
Presentation An obese 73 year old woman with history of hypertension, cholecystectomy and hysteroannessiectomy is referred for abdominal sonography due to a complaint of abdominal pain and constipation.
 
 
 
Caption: B-Mode Sonography of the liver
Description: Transabdominal ultrasound shows a subcapsular well-defined homogeneous hyperechoic mass in segment 7 of the liver.
 
 
Caption: B-Mode Sonography of the liver
Description: Transabdominal ultrasound shows a subcapsular well-defined homogeneous hyperechoic mass in segment 7 of the liver.
 
 
Caption: Color Doppler Sonography
Description: Color Doppler sonogram shows moderate vascularity in the lesion.
 
 
Caption: Histological Findings
Description: Histologically, these lesions consist of mature adipose tissue.
 
Differential Diagnosis
• HEMANGIOMA
• ANGIOMYOLIPOMA
• MYELOLIPOMA
• HEPATOCELLULAR CARCINOMA
• HEPATIC METASTASES
 
Final Diagnosis Hepatic Lipomas
 
Discussion Hepatic lipomas are very rare, asymptomatic, usually accidentally found benign tumors.

Within hepatic parenchyma, one can distinguish:

PURE LIPOMAS:
they are localized in the depth of hepatic parenchyma, they are round in shape and completely surrounded by normal hepatic parenchyma.
PSEUDOLIPOMAS:
they would originate from the Glisson’s capsule and this is the reason why they are also named Capsular Lipomas.  In this case, various intralesional degenerative, necrotic, hemorrhagic and calcific phenomena can be associated. Hepatic lipomas consist of mature adipocytes with constricted surrounding hepatic parenchyma and with peripheral blood vessels.
 
Case References
  1. Roberts JL, Fishman EK, Hartman DS, Sanders R, Goodman Z, Siegelman SS.  Lipomatous tumors of the liver: evaluation with CT and US.  Radiology 1986;158:613-17.
  2. Reading CC, Charboneau JW. Case of the day: Ultrasound: Hepatic lipoma. Radiographics 1990;10:511-12.
  3. Bruneton J, Kerboul P, Drouillard J, Menu Y, Normand F, Santini N. Hepatic lipomas: ultrasound and computed tomographic findings.  Gastrointest Radiol 1987;12:299-303.
  4. Hui-Xiong Xu, MD, PhD, Xiao-Yan Xie, MD, PhD, Ming-De Lu, MD, DMSc, Guang-Jian Liu, MD, Zuo-Feng Xu, MD, Jin-Yu Liang, MD and Li-Da Chen, MD  Unusual Benign Focal Liver Lesions: Findings on Real-time Contrast-Enhanced Sonography  J. Ultrasound Med., February 1, 2008; 27(2): 243 - 254.
  5. Quinn AM, Guzman-Hartman G.  Pseudolipoma of Glisson capsule.  Arch Pathol Lab Med 2003; 127:503–504
 
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