目的:脂肪瘤是罕见但最常见的胃肠道(GI)良性间质病变,由成熟的脂肪细胞组成。\"piggybackinglipoma\"是由上覆息肉样上皮病变的脂肪瘤形成的,如无柄锯齿状病变,管状腺瘤,或者增生性息肉,关于这些病变的文献有限。在这项研究中,我们系统地研究了临床,内窥镜,以及这些独特脂肪瘤的病理特征。
方法:这是一项针对2016-2021年诊断的胃肠道脂肪瘤的单机构回顾性研究。在这项研究中纳入并回顾了在同一内窥镜发作期间并发息肉样上皮或间充质病变的患者。根据并发病变是覆盖在脂肪瘤上还是在肠道的不同位置,脂肪瘤被分类为“负重脂肪瘤”或“非负重脂肪瘤”。人口统计,临床,内镜数据来自电子病历.
结果:本研究共纳入100例伴有上皮或间充质病变的脂肪瘤。其中,21例被归类为“piggybacking脂肪瘤”,79例被归类为“非piggybacking脂肪瘤”。背负式脂肪瘤患者表现为女性好发,并且更可能是有症状的,不太可能表现出脂肪瘤的经典内镜特征。组织学上,piggybacking息肉表现为上覆无柄锯齿状病变(SSL)(76.2%)和管状腺瘤(TA)(19%),而非piggybackgroup组的TA(57.5%)和SSL(6.0%)的特征性病变不同。
结论:负重脂肪瘤是一种罕见的脂肪瘤,伴有上覆息肉样上皮病变,最常见的是SSL。他们提出了不同的临床,内窥镜,和病理特征与非搭载脂肪瘤相比。
OBJECTIVE: Lipomas are rare but the most common benign mesenchymal lesions of the gastrointestinal (GI) tract, composed of mature adipose cells. The \"piggybacking lipoma\" is formed by lipomas with overlying polypoid epithelial lesions, such as sessile serrated lesion, tubular adenoma, or hyperplastic polyp, and the literature on these lesions is limited. In this study, we systematically investigated the clinical, endoscopic, and pathologic characteristics of these unique lipomas.
METHODS: This is a single-institution retrospective study of gastrointestinal tract lipomas diagnosed from 2016-2021. Those with concurrent polypoid epithelial or mesenchymal lesions during the same endoscopic episode were included and reviewed in this study, and the lipomas were classified as \"piggybacking lipoma\" or \"non-piggybacking lipoma\" depending on whether the concurrent lesion was overlying the lipoma or was at a different location in the intestine. Demographic, clinical, and endoscopic data were obtained from electronic medical records.
RESULTS: A total of 100 lipomas with concurrent epithelial or mesenchymal lesions were included in this study. Among them, 21 cases were classified as \"piggybacking lipoma\" and 79 were classified as \"non-piggybacking lipoma\". Patients with piggybacking lipomas showed a female predilection, and were more likely to be symptomatic and less likely to exhibit classic endoscopic features of lipoma. Histologically, the piggybacking polyps showed overlying sessile serrated lesions (SSL) (76.2%) and tubular adenoma (
TA) (19%), whereas the non-piggybacking group had differing characteristic lesions with
TA (57.5%) and SSL (6.0%).
CONCLUSIONS: Piggybacking lipomas are rare lipomas with overlying polypoid epithelial lesions, most commonly SSL. They present different clinical, endoscopic, and pathologic features compared to non-piggybacking lipomas.