Gross and Microscopic Appearance

Intracranial lipomas appear as dark-yellow lesions on gross inspection. The meninx primitiva contains within it "primitive perivascular reticuloendothelium,"6 which may become specialized in the storage of fat, and this may account for the histology of intracranial lipomas. Early precapillary parenchyma may also differentiate into fat cells. Microscopic examination reveals that these lesions are composed of mature adipose cells with peripheral, sometimes indented, small bland nuclei. A col-lagenous capsule that is intimately associated with adjacent brain often surrounds the lipoma. In general, no cleavage plane exists between the tumor and surrounding brain tissue. Histo-logically, although mature fat is the predominant element, variable amounts of fibrovascular tissue, bone, and calcification can also be present. Adjacent parenchymal calcifications and bone formation may occur, although the exact percentage of lipomas showing these changes is not well documented. Bone formation within lipomas appears to be unique to lipomas of the central nervous system6,19,23 and is particularly characteristic in the suprasellar variants (as seen in the previously discussed osteolipomas).

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