Ohbayashi M, Ueda S, Matsumoto K, Tsuda T, Soga T, Shinomiya S
Department of Neurological Surgery, School of Medicine, The University of Tokushima, Japan.
No Shinkei Geka. 1988 Mar;16(3):283-7.
A case of 3-month-old girl with lumbosacral lipoma is reported. She had a large soft tissue mass (4 X 5 cm) in the lumbosacral region initially noted at birth. Interpendicular distances below L2 were dilated on X-P. CT image demonstrated a sharply outlined low density area (approximately -80 H. U.) which occupied the latter half of the spinal canal in the level of L2 to S1 level. Defect of vertebral arch was also seen. Lipoma was removed subtotally with laminectomy. CT image demonstrated clear sharp margin of the tumor, neural tissue free zone were not found intraoperatively. Post-operative course was uneventful. Specimen showed the mature adipose tissue which contained rich blood vessels and connective tissue. Connective tissue was composed of collagen fibers and elastic fibers. Small aberrant nerve fibers and smooth muscle fibers were sporadically noted in specimens obtained from nearby transitional area of its lipoma and spinal cord. Although there were a few reports about the morphology of lipoma, the existence of nerve cell, neuroglia, embryonic bone, cartilage, smooth muscle fiber, striated muscle fiber, respiratory-like cell and others were reported in the previous reports. Our histological findings also suggest that the lipoma possibly arise from pluripotential caudal cell mass which survived by disturbance of the 3rd stage of neural tube formation (retrogressive differentiation).
报告一例3个月大患有腰骶部脂肪瘤的女孩。她在出生时最初被发现腰骶部有一个大的软组织肿块（4×5厘米）。腰椎正位X线片显示L2以下椎弓根间距增宽。CT图像显示一个边界清晰的低密度区（约-80 H.U.），占据了L2至S1水平椎管的后半部分。还可见椎弓缺损。通过椎板切除术部分切除脂肪瘤。CT图像显示肿瘤边界清晰锐利，术中未发现神经组织游离区。术后过程顺利。标本显示为成熟的脂肪组织，含有丰富的血管和结缔组织。结缔组织由胶原纤维和弹性纤维组成。在从脂肪瘤与脊髓附近过渡区域获取的标本中偶尔可见小的异常神经纤维和平滑肌纤维。虽然有一些关于脂肪瘤形态的报道，但先前的报道中还报告了神经细胞、神经胶质、胚胎骨、软骨、平滑肌纤维、横纹肌纤维、类呼吸细胞等的存在。我们的组织学发现也表明，脂肪瘤可能起源于多能尾侧细胞团，该细胞团因神经管形成第三阶段的干扰（逆行分化）而存活下来。
