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PubMed1977

Macrodystrophia lipomatosa: radiographic diagnosis.

Macrodystrophia lipomatosa is a rare form of localized gigantism characterized by progressive overgrowth of all the mesenchymal elements with a disaproportionate increase in the fibroadipose tissues. This congenital abnormality occurs most frequently in the distribution of the median nerve in the upper extremity and in the distribution of the planter nerves in the lower extremity. It is usually recognized at birth or in the neonatal period. As the patient grows, the deformity begins to mechanically interfere with joint function, vascular supply, and innervation. Six cases are described with emphasis on the radiographic findings which differentiate this entity from other forms of local gigantism. These findings include a predominately distal involvement, enlargement of the phalanges and soft tissue elements of the digit, and lucencies within the soft tissues.

Adult↗
PubMed1980

CT diagnosis of benign mediastinal abnormalities.

Thoracic CT scanning was performed in 49 adult male patients to evaluate a suspected mediastinal mass. A correct diagnosis would have been made in only 20 instances on the basis of conventional chest radiography. Specific diagnoses established by CT included 14 cases of local or diffuse mediastinal fat deposition, five mediastinal cysts, and six anomalies or aneurysms of the great vessels. Four miscellaneous lesions were also clarified. Thoracic angiography would undoubtedly have diagnosed vascular abnormalities, but was obviated in most instances. CT accurately defined anatomic relationships and distinguished vascular from nonvascular masses in the 16 patients who underwent diagnostic thoracotomy or mediastinoscopy. When CT demonstrated a fatty or cystic lesion, no attempt at tissue confirmation was undertaken in all but two of the asymptomatic patients. Clinical follow-up from 6 months to 3 years in conjunction with select correlative radiologic procedures have supported the CT findings in the nonoperated group. CT should be the initial procedure for evaluating most patients with mediastinal abnormalities detected by plain chest radiography. If the patient is asymptomatic and the information provided by CT indicates a benign process, conservative management with careful follow-up is justified.

Adult↗
PubMed1983

Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma.

All 428 patients who had a non-visceral lipoma histopathologically diagnosed during 1 year in a defined population (0.74 million inhabitants) were analysed retrospectively as regards the age, duration of symptoms, size, site (location and depth) and multiplicity of the lipomas. Solitary subcutaneous lipomas were uncommon in the hand, thigh, lower leg and foot, and four-fifths of them (264/338) were smaller than 5 cm. Multiple subcutaneous lipomas were found in 61 patients, most of them young males. Subfascial lipomas, with a mean size (6 cm) double that of solitary subcutaneous lipomas, were found in 13 patients. A subgroup of 192 lipomas (153 patients) was reexamined histologically and the tumours were classified as either simple lipoma or angiolipoma. Angiolipomas were significantly more common in patients with multiple lipomas. To assess the reliability of a clinical diagnosis of lipoma as well as the proportion of clinically diagnosed lipomas not verified by histology, the records of patients seen in one department of surgery and in one health care centre were examined. Based on these data, the annual clinical incidence of lipoma (number of patients consulting a doctor for a lipoma, even if not histologically verified) was estimated to be 1/1000. When the data for solitary lipomas were compared to those for soft-tissue sarcoma, it was found that patient age and duration of symptoms were of minor value in the clinical differential diagnosis. However, if a tumour were (a) larger than 5 cm, irrespective of depth and location, (b) located in the thigh, irrespective of depth and size, or (c) deep, irrespective of location and size, it was more likely to be a sarcoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗