Öz
Pancreatic lipomas are mesenchymal tumors of pancreas and limited numbers of cases were reported in the literature. Lesion is asymptomatic unless it is a large mass or it causes compression findings. Because of the limitations in sonographic evaluation of pancreas, it can be difficult detecting lesions especially the small ones. In computed tomography (CT) and magnetic resonance imaging (MRI) they have homogenous internal structure, smooth borders and same density/intensity like fat tissues at the other parts of body. They do not enhance, or extend to peripancreatic fat tissue. Fat containing lesions like focal fatty infiltration, teratoma, and liposarcoma are in differential diagnosis. It is particularly important to differentiate from liposarcoma which is malignant. Bigger size (>5cm), heterogeneous internal structure, contrast enhancement and size increasing are in favor of malignancy. CT and MRI are very important in detecting and differential diagnosis of lipomas.
Anahtar Kelimeler
Kaynakça
- 1. Hois EL, Hibbeln F, Sclamberg JS. CT appearance of incidental pancreatic lipomas. Abdom Imaging 2006; 31:332-8.
- 2. Lee SY, Thng CH, Chow PKH. Lipoma of the pancreas, a case report and a review of the literature. World J Radiol 2011; 3(10): 246-8.
- 3. Barutcu O, Cihangiroglu M, Yildirim T, Kayaselcuk F, Noyan T. Fat containing unusual tumor of the pancreas. Eur Radiol 2002;12:770-3.
- 4. Stadnik A, Cieszanowski A, Bakon L, Grodzicka A, Rowinski O. Pancreatic lipoma: An incidentiloma which resemble cancer- analysis of 13 cases studied with CT and MRI. Pol J Radiol 2012; 77(3): 9-13.
- 5. Secil M, Igci E, Goktay AY, Dicle O. Lipoma of the pancreas: MRI findings. Comput Med Imaging Graph 2001; 25: 507-9.
- 6. Karaosmanoglu D, Karcaaltincaba M, Akata D, Ozmen M, Akhan O. Pancreatic lipoma computed tomography diagnosis of 17 patients and follow-up. Pancreas. 2008;36:434–436.
- 7. Lee JY, Seo H, Park EY, Kim GH, Park DY, Kim S. Histologic confirmation of huge pancreatic lipoma: a case report and review of literatures. J Korean Surg Soc 2011;81:427-30.
- 8. Bigard MA, Boissel P, Regent D, Froment N. Intrapancreatic lipoma: first case in the literature. Gastroentrol Clin Biol. 1989; 13:505-7.
- 9. Itai Y, Saida Y, Kurosaki Y, Kurosaki A, Fujimoto T. Focal fatty masses of the pancreas. Acta Radiol 1995; 36: 178-81.
- 10. Katz DS, Nardi PM, Hines J, Brackhausen R, Math KR, Fruauff AA, Lane MJ. Lipomas of pancreas. Am J Roentgenol 1998; 170: 1485-7.
- 11. Kim HJ, Byun JH, Park SH, Shin YM, Kim PN, Ha HK, Lee M. Focal fatty replacement of the pancreas: Usefulness of chemical shift MRI. AJR 2007; 188:429–432.
- 12. Lee LS, Kim SH, Jun DW et al. Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome. World J Gastroenterol 2009 April 21; 15(15): 1869-75.
- 13. Suzuki R, Irisawa A, Hikichi T, Shibukawa G et al. Pancreatic lipoma diagnosed using EUS-FNA. A case report. J Pancreas (Online) 2009; 10(2):200-203.
Öz
Pankreatik lipomlar pankreasın mezenkimal tümörleri olup literatürde sınırlı sayıda olgu bildirilmiştir. Lezyon büyük olmadığı ya da bası bulguları oluşturmadığı sürece asemptomatiktir. Pankreasın ultrasonografi (USG) ile değerlendirilmesindeki sınırlılıklar nedeniyle özellikle küçük boyutlu lezyonların USG ile tespiti güç olabilir. Bilgisayarlı tomografi (BT) ve magnetik rezonans görüntülemede (MRG) homojen iç yapıda, düzgün sınırlı, vücudun diğer bölgelerindeki yağ doku ile benzer dansite/sinyal özelliği gösterirler. Kontrast tutulumu ve peripankreatik yağ dokuya uzanımları görülmez. Ayırıcı tanıda fokal yağlı infiltrasyon, teratom, liposarkom gibi yağ doku içeren lezyonlar bulunur. Özellikle malign tümör olan liposarkomdan ayrım önemlidir. Lezyonun büyük boyutta (>5cm) ve heterojen iç yapıda olması, kontrast tutulumu göstermesi, takipte boyut artışı malignite lehinedir. BT ve MRG lipomların tespiti ve ayırıcı tanısında çok önemlidir.
Anahtar Kelimeler
Kaynakça
- 1. Hois EL, Hibbeln F, Sclamberg JS. CT appearance of incidental pancreatic lipomas. Abdom Imaging 2006; 31:332-8.
- 2. Lee SY, Thng CH, Chow PKH. Lipoma of the pancreas, a case report and a review of the literature. World J Radiol 2011; 3(10): 246-8.
- 3. Barutcu O, Cihangiroglu M, Yildirim T, Kayaselcuk F, Noyan T. Fat containing unusual tumor of the pancreas. Eur Radiol 2002;12:770-3.
- 4. Stadnik A, Cieszanowski A, Bakon L, Grodzicka A, Rowinski O. Pancreatic lipoma: An incidentiloma which resemble cancer- analysis of 13 cases studied with CT and MRI. Pol J Radiol 2012; 77(3): 9-13.
- 5. Secil M, Igci E, Goktay AY, Dicle O. Lipoma of the pancreas: MRI findings. Comput Med Imaging Graph 2001; 25: 507-9.
- 6. Karaosmanoglu D, Karcaaltincaba M, Akata D, Ozmen M, Akhan O. Pancreatic lipoma computed tomography diagnosis of 17 patients and follow-up. Pancreas. 2008;36:434–436.
- 7. Lee JY, Seo H, Park EY, Kim GH, Park DY, Kim S. Histologic confirmation of huge pancreatic lipoma: a case report and review of literatures. J Korean Surg Soc 2011;81:427-30.
- 8. Bigard MA, Boissel P, Regent D, Froment N. Intrapancreatic lipoma: first case in the literature. Gastroentrol Clin Biol. 1989; 13:505-7.
- 9. Itai Y, Saida Y, Kurosaki Y, Kurosaki A, Fujimoto T. Focal fatty masses of the pancreas. Acta Radiol 1995; 36: 178-81.
- 10. Katz DS, Nardi PM, Hines J, Brackhausen R, Math KR, Fruauff AA, Lane MJ. Lipomas of pancreas. Am J Roentgenol 1998; 170: 1485-7.
- 11. Kim HJ, Byun JH, Park SH, Shin YM, Kim PN, Ha HK, Lee M. Focal fatty replacement of the pancreas: Usefulness of chemical shift MRI. AJR 2007; 188:429–432.
- 12. Lee LS, Kim SH, Jun DW et al. Clinical implications of fatty pancreas: Correlations between fatty pancreas and metabolic syndrome. World J Gastroenterol 2009 April 21; 15(15): 1869-75.
- 13. Suzuki R, Irisawa A, Hikichi T, Shibukawa G et al. Pancreatic lipoma diagnosed using EUS-FNA. A case report. J Pancreas (Online) 2009; 10(2):200-203.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2013 |
| Gönderilme Tarihi | 5 Haziran 2013 |
| Yayımlandığı Sayı | Yıl 2013 Cilt: 2 Sayı: 3 |
Bu eser Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı ile lisanslanmıştır.