[Radiological aspects of lipomas of the spinal column. A report on four cases (author's transl)].

Observation of the four cases reported and a review of the published literature suggest that spinal column lipomas can produce two entirely unrelated types of radiological image. 1. An image of cord-like appearance and variable width which joins the filum terminale to the sacrum, and is usually associated with enlargement of the spinal cord at the same level. This image can be demonstrated by both gas myelography and opaque myelography, and is produced by a lipoma of the filum terminale. The cord image is either that of an ectopic spinal cord or that of the lipomatous tumor itself, which joins the filum terminale to the sacrum. A spina bifida is often associated with these tumors, which can be intradural alone, which is very rare, or both intradural and epidural, and are often associated with enlargement of the spinal canal. 2. A fairly specific blocking-type of image which can be seen by opaque myelography, and consists of fringed bands which become progressively shorter from above downwards until being completely blocked. This appearance, which is extremely rare, is peculiar to intramedullary lipomas, the image probably corresponding to the dissociation of the medullary fiber bundles by the tumoral cords.