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PubMed1990

Comparison of the effects of dietary beef tallow and corn oil on pancreatic carcinogenesis in the hamster model.

We previously reported an enhancement of pancreatic carcinogenesis induced by N-nitrosobis(2-oxopropyl)amine (BOP) in hamsters fed diets containing high levels of corn oil. The research presented here compared diets high in corn oil with those high in beef tallow in the enhancement of pancreatic carcinogenesis. Pancreatic cancer was induced with 20 mg BOP/kg body wt, s.c. administered at 8 weeks of age. One week later, hamsters were assigned to one of five diet treatments: (i) 4.3% corn oil (control); (ii) 20.5% corn oil (high corn oil); (iii) 0.5% corn oil + 3.8% beef tallow (low beef tallow); (iv) 0.6% corn oil + 19.9% beef tallow (high beef tallow); and (v) 5.1% corn oil + 15.4% beef tallow (high fat mixture). These diets were fed until the study ended 84 weeks after BOP treatment. Hamsters were trained through pair feeding to consume the same calorie allotment as the control corn oil group. By the end of the experiment, BOP-treated hamsters that were fed diets containing beef tallow were consistently heavier than those fed corn oil. Survival was longer in hamsters fed the high-beef tallow and high-fat mixture compared with the other diet groups. Tumor data were age adjusted to correct for survival differences. Pancreatic adenoma incidence and multiplicity (no./effective animal) were higher in hamsters fed beef tallow than those fed corn oil diets. Carcinoma in situ multiplicity was elevated in hamsters fed high-fat diets irrespective of the nature of fat fed. Pancreatic adenocarcinoma multiplicity was elevated in hamsters fed the low- or high-beef tallow diets compared with the low- or high-corn oil diets. The mixture of fat resulted in an intermediate yield.

Adenocarcinoma↗
PubMed1998

Pseudolipomatosis cutis: superficial dermal vacuoles resembling fatty infiltration of the skin.

Empty spaces within the dermis of paraffin-embedded sections of skin have been attributed to fatty infiltration and postulated to originate from topical steroid administration or sebaceous gland rupture. We examined skin biopsy specimens exhibiting dermal vacuolation to determine whether this phenomenon was associated with specific skin diseases and to attempt to illuminate its etiology. Routine hematoxylin-eosin-stained sections from 26 formalin-fixed, paraffin-embedded biopsy specimens were examined. Histochemical stains for mucin and immunohistochemical staining for S100 protein and vascular markers were performed. Dermal vacuolation was characterized by empty spaces, 15-120 microm in diameter, in the superficial dermis, associated with either fibrosis/sclerosis or a lymphocytic infiltrate. There was no relationship to clinical findings, topical steroid treatment, or histologic diagnosis. There was no evidence of true adipocyte differentiation, and vascular markers were negative. Transmission electron microscopy showed nonmembrane-bound irregular spaces in the dermis. Dermal vacuoles likely represent an artifact of tissue fixation or processing and are unrelated to the underlying pathologic process. We propose the name pseudolipomatosis cutis, analogous to insufflation-induced colonic vacuolation, to distinguish this phenomenon from true dermal fatty infiltration and to emphasize its incidental, likely artifactual nature.

Adipocytes↗
PubMed2003

Hyperplasia of the subcutaneous adipose tissue is the primary histopathologic abnormality in lipedematous scalp.

A 51-year-old white woman presented with thickening of the scalp located at the vertex and left lateral occiput without hair abnormalities or alopecia. Skin biopsies of the thickened scalp showed thickening of the subcutaneous tissue with proliferation of mature subcutaneous fat cells but no signs of inflammation or hair abnormalities. During 2.5 years of follow-up, scalp thickening progressed over the entire hair-bearing scalp and persisted without signs of further progression at 3.5 year follow-up. Lipedematous scalp is an extremely rare diagnosis. It is defined by a thickening of the subcutaneous layer of the scalp and can be distinguished from lipedematous alopecia, in which subcutaneous thickening is associated with diffuse alopecia and shortening of scalp hairs. A total of seven cases of lipedematous alopecia and two cases of lipedematous scalp have been reported. We report the third case of lipedematous scalp in a 51-year-old white woman associated with early symptoms of meningitis. Additional features described in the literature include pruritus, pain, and paresthesia of the scalp as well as associated medical problems such as hyperelasticity of skin and laxity of joints, renal failure, and diabetes mellitus. This sporadic disorder is predominantly located at the vertex and occiput. The etiology and pathogenesis of lipedematous scalp and alopecia remain unclear. The treatment is symptomatic.

Adipose Tissue↗
PubMed1996

Lipomatous hypertrophy of the atrial septum presenting as a right atrial mass.

Lipomatous hypertrophy of the atrial septum (LHAS) has been associated with cardiac arrhythmias and is defined as fatty infiltration > 2 cm thick in the atrial septum. The clinical and histologic features of surgically excised LHAS have not been previously studied. We studied 11 surgical resections of LHAS and compared them with 13 autopsy cases of LHAS and 24 control autopsy hearts. Of 11 surgical patients, eight were women: patients' mean age was 63 years, and six were described as mildly to overtly obese. Symptoms included congestive heart failure, atrial fibrillation, supraventricular tachycardia, palpitations, syncope, and incidental mass found at surgery. Imagining studies typically revealed a right atrial mass with a mean size of 6 cm (range, 2.5-10 cm). Multivacuolated fat was more extensive in surgical (p = 0.005) and autopsy (p = 0.009) cases of LHAS than in control hearts. Atypical, hypertrophied myocytes were presented in 72% of cases of LHAS compared with 8% of controls (p = 0.0003). In autopsy hearts, histologically abundant multivacuolated fat, heart weight, and body size were independently associated with increased atrial septal thickness. LHAS can be surgically excised, it has a distinctive histologic appearance marked by the presence of abundant multivacuolated fat and hypertrophied myocytes, and it is associated with increased body and cardiac mass.

Adipocytes↗
PubMed1997

Lipoblastoma/lipoblastomatosis: a clinicopathologic study of 25 tumors.

Lipoblastoma/lipoblastomatosis is an uncommon benign adipose tissue tumor of children. Since 1958, 25 of these tumors from 24 patients have been reviewed in the Department of Pathology at The Children's Hospital of Philadelphia. Tumors were resected from 19 boys (79%) and five girls, and 20 patients (84%) were < or =5 years of age at diagnosis. Twenty-three tumors presented as painless superficial soft-tissue masses; one tumor was retroperitoneal and was discovered because of vomiting; one hand tumor was present at birth. Tumors occurred in an extremity (n = 11 patients), the head and neck (n = 5), groin (n = 2), axilla (n = 2), back (n = 1), chest (n = 1), flank (n = 1), labia (n = 1), and retroperitoneum (n = 1). Thirteen tumors occurred on the left side, and five occurred on the right. Lesions measured 1.0-21.0 cm in greatest dimension; 15 of 25 (60%) measured < or =5.0 cm. The largest (retroperitoneal) tumor weighed 450 g. Eleven tumors were discrete lipoblastoma, and 14 had irregular margins (lipoblastomatosis). Microscopically, the tumors displayed adipocytes in different stages of maturation; lobules bordered by septae that were cellular in 11 cases; prominent blood vessels in 19 cases; and myxoid foci in 13 cases. Chart review of 22 patients showed that one tumor recurred 4 years after resection; one tumor recurred after 7 years as fibrolipoma; and one incompletely resected tumor enlarged and at second resection was lipoma. There were no metastases. Three patients also had hemangioma. Juvenile aponeurotic fibroma occurred in one patient near the site of resection of a lipoblastoma 4 years earlier. We conclude that lipoblastoma/lipoblastomatosis behaves benignly, occurs in both superficial and deep sites, occasionally attains large size, may mature, can recur, and may be associated with other benign soft-tissue lesions. Complete surgical excision is the treatment of choice.

Adolescent↗
PubMed1978

Benign fatty tumors of the peripheral nerves.

Fatty tumors of the peripheral nerves, although rare, occur with sufficient frequency to pose problems in diagnosis and treatment. Moreover, the nomenclature of these tumors has suffered from controversy over their morpological description. These factors have contributed to a misunderstanding about the treatment of these localized nerve abnormalities leading, in the past, to unnecessary radical nerve excisions with resultant total motor and sensory deficit. This paper reviews the various types of fatty tumors, describes the morphology and pathophysiology of one such lesion, and provides a basis for a rational surgical approach.

Adolescent↗
PubMed1987

Suction extraction of lipomas.

With the use of suction-assisted lipectomy techniques in treatment of lipomas, the length and number of surgical scars may be minimized. The procedure is reviewed and several clinical applications are presented. Because no long-term recurrence rates are known, caution must be exercised in recommending this procedure to the patient.

Adipose Tissue↗
PubMed2001

Madelung's disease: case report and discussion of treatment options.

Madelung's disease was first described in 1846. Since then, approximately 200 patients have been reported in the literature. Its three main characteristics-typical location of the lesions, symmetry, and the diffusive nature of the fat-are more often found in men of Mediterranean descent. A clear association with alcohol abuse is reported, but the etiology remains uncertain. Patients usually complain of their cosmetic appearance, but treatment can be rendered for decreased neck motion and/or aerodigestive problems. Given the benign nature of the lesion, surgical debulking is the treatment of choice, with liposuction reserved for smaller lesions. A standard facelift pattern can be used for skin incisions and removal, with good cosmetic results.

Aged↗
PubMed2002

Atypical lipomatous masses of the extremities: outcome of surgical treatment.

Atypical lipomatous tumors occur predominantly in middle-aged patients and often present as painless, slow-growing masses in the extremities. The clinical outcomes of surgically treated superficial or deep atypical lipomas of the extremities were reviewed. Thirty-one patients were included in this study. There were 16 men and 15 women, with an average age of 57 years (range, 32-87 years). The mean followup was 7 years (range, 1-28.8 years). Twenty-five tumors occurred in the lower extremity and six in the upper extremity. Sixteen patients (52%) had a recurrence at an average of 4.7 years after resection. Twelve (39%) patients required additional surgical procedures to treat their tumor. Occurrence of a deep lesion and positive margins at the time of the initial surgery correlated closely with the rate of recurrence and need for additional surgical treatment. Dedifferentiation to high-grade liposarcoma developed in four (13%) patients. Atypical lipomas have a high propensity for local recurrence and a potential for malignant dedifferentiation. Patients with atypical lipomas require careful evaluation, complete surgical excision when possible, and close clinical followup extending beyond 5 years.

Adult↗
PubMed1997

Evolving stages of lipohemarthrosis of the knee. Sequential magnetic resonance imaging findings in cadavers with clinical correlation.

RATIONALE AND OBJECTIVES: Lipohemarthrosis, the presence of fat and blood in a joint cavity, exhibits several complex layers related to differences in specific component relaxation on magnetic resonance (MR) images. The authors investigated sequential changes in the appearance of lipohemarthrosis of the knee as demonstrated by MR imaging. METHODS: Sequential MR imaging over a 4-day period was performed on two cadaveric knees after intraarticular injection of blood from a volunteer and fat from a cadaveric tibia (50 mL of blood and 25 mL of fat in one knee and 15 mL of blood and 5 mL of fat in the other knee). The authors determined components in the joint based on MR signal behavior. Magnetic resonance imaging examinations of four patients with intracapsular fractures and lipohemarthroses of the knee were reviewed retrospectively. RESULTS: Sequential MR images of cadaveric knees showed serial changes representing progressive formation and lysis of blood clot. Several fluid-fluid levels (globules of fat at the interface between fat and blood) and entrapment of fat were early findings of lipohemarthrosis. Three different fluid levels appeared approximately 3 hours after injection of fresh blood and marrow fat. The 96-hour study demonstrated three distinct levels. CONCLUSIONS: Lipohemarthrosis demonstrates temporal changes on MR imaging related to stages of formation and lysis of blood clot.

Adult↗