Background Hibernoma is a rare benign tumor of adults that is composed of multivacuolated adipocytes resembling brown fat cells. Hibernoma typically occurs in soft tissue, and intraosseous examples are very rare. Intraosseous hibernomas can radiologically mimic metastatic carcinoma and other tumorous conditions. Methods: To collect the intraosseous hibernomas, we searched the pathologic database and reviewed the hematoxylin and eosin (H&E)–stained slides of bone biopsy samples performed to differentiate radiologically abnormal bone lesions from 2006 to 2016. A total of six intraosseous hibernoma cases were collected, and clinical and radiological information was verified from electronic medical records. H&E slide review and immunohistochemical staining for CD68, pan-cytokeratin, and S-100 protein were performed. Results: Magnetic resonance imaging of intraosseous hibernomas showed low signal intensity with slightly hyperintense foci on T1 and intermediate to high signal intensity on T2 weighted images. Intraosseous hibernomas appeared as heterogeneous sclerotic lesions with trabecular thickening on computed tomography scans and revealed mild hypermetabolism on positron emission tomography scans. Histopathologically, the bone marrow space was replaced by sheets of multivacuolated, foamy adipocytes resembling brown fat cells, without destruction of bone trabeculae. In immunohistochemical analysis, the tumor cells were negative for CD68 and pan-cytokeratin and positive for S-100 protein. Conclusions: Intraosseous hibernoma is very rare. This tumor can be overlooked due to its rarity and resemblance to bone marrow fat. Pathologists need to be aware of this entity to avoid misdiagnosis of this rare lesion.
Citations
Citations to this article as recorded by
A Rare Case of Large Lateral Chest Wall Hibernoma Lyubomir Gaydarski, Boycho Landzhov, Ivaylo Kamenov, Julian M Ananiev, Georgi P Georgiev Cureus.2024;[Epub] CrossRef
Intraosseous hibernoma mimicking sclerotic bone metastasis—a case report Ali Shaikh, Adil Basha, George Ray, Justin A. Bishop, Avneesh Chhabra Skeletal Radiology.2024;[Epub] CrossRef
Femoral hibernoma: unique intraosseous tumor Gökhan Tonkaz, Ertugrul Cakir, Mehmet Tonkaz, Demet Sengul Wiener klinische Wochenschrift.2024; 136(19-20): 581. CrossRef
Unusual Imaging Findings of Epithelioid Hemangioma: Case Report of Single Intramedullary Sclerotic Bone Lesion Yun Chul Hwang, Tae Eun Kim, Jae Hyuck Yi Journal of the Korean Society of Radiology.2024; 85(5): 986. CrossRef
Benign incidental do-not-touch bone lesions Nuttaya Pattamapaspong, Wilfred CG Peh The British Journal of Radiology.2023;[Epub] CrossRef
Intraosseous hibernoma: clinicopathologic and imaging analysis of 18 cases Chiraag N Gangahar, Carina A Dehner, David P Wang, Behrang Amini, Travis Hillen, Christopher O'Conor, Sydney N Jennings, Kathleen Byrnes, Elizabeth A Montgomery, Bogdan A Czerniak, Julia A Bridge, Molly C Schroeder, Jack W Jennings, Wei‐Lien Wang, John S Histopathology.2023; 83(1): 40. CrossRef
Intraosseous Hibernoma: A Rare Entity in Orthopedics With Peculiar Radiological Features Ramy Samargandi, Louis-Romée Le Nail, Gonzague de Pinieux, Matthias Tallegas, Elodie Miquelestorena-Standley Cureus.2023;[Epub] CrossRef
Intraosseous hibernoma of the appendicular skeleton Salvatore Gitto, Thom Doeleman, Michiel A. J. van de Sande, Kirsten van Langevelde Skeletal Radiology.2022; 51(6): 1325. CrossRef
Intraosseous hibernoma: Two case reports and a review of the literature Samantha N. Weiss, Ankit Mohla, Gord Guo Zhu, Christina Gutowski, Tae Won B Kim, Rohan Amin Radiology Case Reports.2022; 17(7): 2477. CrossRef
Hibernoma of two contiguous vertebrae: uniqueness of a lesion already rare in itself Donato MASTRANTUONO, Domenico MARTORANO, Guido REGIS, Federica ARABIA, Alessandra LINARI, Federica SANTORO Journal of Radiological Review.2022;[Epub] CrossRef
Primary extradural tumors of the spinal column Varun Arvind, Edin Nevzati, Maged Ghaly, Mansoor Nasim, Mazda Farshad, Roman Guggenberger, Daniel Sciubba, Alexander Spiessberger Journal of Craniovertebral Junction and Spine.2021; 12(4): 336. CrossRef
Spinal Intraosseous Hibernoma: A Case Report and Review of Literature Mi-Kyung Um, Eugene Lee, Joon Woo Lee, Kyu Sang Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang Journal of the Korean Society of Radiology.2020; 81(4): 965. CrossRef
Intraosseous hibernoma: A metastatic mimicker to consider on the differential Allen Ko, Colin C. Rowell, James B. Vogler, Dmitri E. Samoilov Radiology Case Reports.2020; 15(12): 2677. CrossRef
Co-expression of MDM2 and CDK4 in transformed human mesenchymal stem cells causes high-grade sarcoma with a dedifferentiated liposarcoma-like morphology Yu Jin Kim, Mingi Kim, Hyung Kyu Park, Dan Bi Yu, Kyungsoo Jung, Kyoung Song, Yoon-La Choi Laboratory Investigation.2019; 99(9): 1309. CrossRef
Intraosseous Hibernoma: Five Cases and a Review of the Literature Francisco A. Myslicki, Andrew E. Rosenberg, Ivan Chaitowitz, Ty K. Subhawong Journal of Computer Assisted Tomography.2019; 43(5): 793. CrossRef
Hibernoma Mimicking Atypical Lipomatous Tumor Youssef Al Hmada, Inga-Marie Schaefer, Christopher D.M. Fletcher American Journal of Surgical Pathology.2018; 42(7): 951. CrossRef
Hibernoma is a rare, benign adipose tumor composed of brown fat cells with eosinophilic granular or multivacuolated cytoplasm. The cytologic features of hibernoma have been rarely reported and may mimic other polygonal cell neoplasms. We report the imprint cytologic features of a case of hibernoma in the left thigh of a 68-year-old woman.
Microscopic examination showed large, round, or polygonal brown fat cells. The cells were arranged in fragments or clusters. The nuclei were uniformly round with finely granular chromatin. The cytoplasm was multivacuolated or univacuolated. The abundant eosinophilic granular cytoplasm was also present. No nuclear atypia were present.
Immunohistochemical staining showed that cells were positive for S-100 protein.
Citations
Citations to this article as recorded by
Hibernoma-A rare tumor on rare site Himachal Mishra, Manika Alexander IP Journal of Diagnostic Pathology and Oncology.2023; 7(4): 276. CrossRef