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British Journal of Radiology (2003) 76, 264-267
© 2003 British Institute of Radiology
doi: 10.1259/bjr/31110098
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Paraffinoma in anterior abdominal wall mimicking liposarcoma

K T Wong, MBChB, FRCR1, P S F Lee, MBBS, FRCR1, Y L Chan, MBBS, FRCR1 and L T C Chow, MD, FRCPath, FRCPA2

1 Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin and 2 Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Shatin, Hong Kong



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  		Figure 1. Transverse extended field-of-view high-frequency ultrasound image showing heterogeneous echoes in subcutaneous layer of right anterior abdominal wall casting marked posterior acoustic shadowing. The deep extent of the lesion and underlying abdominal wall muscle cannot be properly assessed. Small anechoic cysts (arrows) are present in its periphery.

 


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  		Figure 2. (a) T1 weighted axial MR image of abdomen showing heterogeneous signal with ill-defined margin in subcutaneous fat of right anterior abdominal wall. It is of predominantly intermediate signal intensity and isointense to adjacent muscle. Areas of signal intensity identical to subcutaneous fat were demonstrated (arrow). Small round hypointense foci are also detected in the periphery part of the lesion (open arrows). (b) Fat-suppressed T2 weighted axial MR images of abdomen showing heterogeneous predominantly low signal intensity in subcutaneous layer of right anterior abdominal wall. High signal changes are present in right external oblique muscle (arrow) which are contiguous with the overlying subcutaneous lesion. Small round peripheral markedly hypointense foci are also demonstrated (open arrows) corresponding to the findings on T1 weighted image.

 


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  		Figure 3. (a) Cut surface of the excised specimen shows lobulated fatty material with evenly scattered small nodules that show a nearly transparent oily cut surface. (b) Histology of the lesion consists of vacuolated spaces of varying sizes, with surrounding multinucleated giant cells, that scatter throughout a background of fat cells and foamy histiocytes. Lipoblasts-like cells are also seen.

 




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