PMC4061575_01
Noncontrasted CT head axial images indicate a right frontal bony lesion with mixed fat and boney trabeculae. (a) Brain windowing, (d) Bone windowing. MRI brain, (b) T1-weighted image, (c) Contrast enhanced image, (e) Sagittal T1 image, (f) Coronal contrast enhanced image
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F1
Noncontrast computed tomography (CT) head indicated a 4.3 x 2.2 x 1.7 cm right frontal calvarial lesion, with internal trabeculated bone mixed with fatty components, and no associated involvement of overlying soft tissue or brain parenchyma [Figure 1]. Magnetic resonance imaging (MRI) of the brain confirmed the presence of a right sided heterogeneously enhancing calvarial lesion with mild mass effect on the adjacent frontal lobe [Figure 1].
Microscopic images showing the lesion and the characteristic features of an intraosseous angiolipoma. (a) The bone (arrow) is expanded by an underlying vascular and fatty lesion (x 4 magnification). (b)The lesion involves the leptomeninges (arrow) (x 4 magnification) (c) Trabeculation of bone within the lesion intermixed with the adipocytes and vessels (x 4 magnification). (d) More prominent vasculature (x 10 magnification). (e) The lesion showing evenly sized bland adipocytes and interspersed small vessels (x 10 magnification). (f) T hin fibrous septa separating the adipocytes, which lack dysplasia or hyperchromasia. The arrow shows a fibrin thrombus (x 20 magnification)
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F2
Microscopically, the lesion consisted of mature trabecular bone intermixed with mature adipocytes and variably sized dilated vascular channels [Figure 2].