LymphedemaV1, PascalFrancis, Corpus, bibRecord, 000A66

Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma

Identifieur interne : 000A66 ( PascalFrancis/Corpus ); précédent : 000A65; suivant : 000A67

Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma

Auteurs : G. Farshid ; S. W. Weiss

Source :

The American journal of surgical pathology [ 0147-5185 ] ; 1998.

RBID : Pascal:98-0492971

Descripteurs français

Pascal (Inist)
- Lymphoedème, Localisé, Membre, Liposarcome, Obésité, Tomodensitométrie, Exploration clinique, Anatomopathologie, Diagnostic différentiel, Etude cas, Adulte, Sarcome, Etat nutritionnel.

English descriptors

KwdEn :
- Adult, Case study, Clinical investigation, Computerized axial tomography, Differential diagnostic, Limb, Liposarcoma, Localized, Lymphedema, Nutritional status, Obesity, Pathology, Sarcoma.

Abstract

We report 14 cases of a soft tissue lesion in the limbs of morbidly obese adults that presents as a large mass and histologically simulates well-differentiated liposarcoma (WDL). Based on its distinctive clinical setting and morphologic identity to diffuse lymphedema we have termed this process massive localized lymphedema (MLL). All cases occurred in morbidly obese adults (mean weight 372 Ibs; mean age 47 years). Women predominated (9 women: 5 men). The lesions affected the proximal medial aspect of the extremities (12 thigh : 2 arm) and were unilateral in all but two patients. Etiologically significant antecedent events include ipsilateral axillary lymphadenectomy in both patients with arm lesions, chronic lymphedema resulting from vein-stripping 10 years prior in one patient, inguinal lymphadenectomy for anal carcinoma in another patient, and significant blunt trauma to the inner thigh during a motor vehicle accident in a third patient. The tumors were long standing (1-10 years) and extremely large (mean size 33.4 cm. 7408 g). Clinically, they were diffuse, ill-defined masses that histologically consisted of lobules of mature fat interrupted by expanded connective tissue septa. The constituents of the septa were fine, fibrillary collagen, edema fluid, and uniformly distributed fibroblasts. Clusters of capillaries were frequently found at the interface between fat and connective tissue. The widened septa simulated the fibrous bands of sclerosing WDL, but MLL lacks the degree of nuclear atypia seen in the former. The consistent clustering of reactive vessels at the interface between the fat and fibrous tissue also contrasted with WDL. Six patients experienced persistent or recurrent lesions within 10 months to 10 years. No aggressive growth or histologic progression was observed during this time, however. Awareness of the features of MLL is important to avoid misclassification of this reactive lesion with WDL.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A08	`01`	`1`	`ENG`	`@1 Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma`
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A14	`01`			`@1 Department of Pathology, University of Michigan Hospitals @2 Ann Arbor, Michigan @3 USA @Z 1 aut. @Z 2 aut.`
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C01	`01`		`ENG`	@0 We report 14 cases of a soft tissue lesion in the limbs of morbidly obese adults that presents as a large mass and histologically simulates well-differentiated liposarcoma (WDL). Based on its distinctive clinical setting and morphologic identity to diffuse lymphedema we have termed this process massive localized lymphedema (MLL). All cases occurred in morbidly obese adults (mean weight 372 Ibs; mean age 47 years). Women predominated (9 women: 5 men). The lesions affected the proximal medial aspect of the extremities (12 thigh : 2 arm) and were unilateral in all but two patients. Etiologically significant antecedent events include ipsilateral axillary lymphadenectomy in both patients with arm lesions, chronic lymphedema resulting from vein-stripping 10 years prior in one patient, inguinal lymphadenectomy for anal carcinoma in another patient, and significant blunt trauma to the inner thigh during a motor vehicle accident in a third patient. The tumors were long standing (1-10 years) and extremely large (mean size 33.4 cm. 7408 g). Clinically, they were diffuse, ill-defined masses that histologically consisted of lobules of mature fat interrupted by expanded connective tissue septa. The constituents of the septa were fine, fibrillary collagen, edema fluid, and uniformly distributed fibroblasts. Clusters of capillaries were frequently found at the interface between fat and connective tissue. The widened septa simulated the fibrous bands of sclerosing WDL, but MLL lacks the degree of nuclear atypia seen in the former. The consistent clustering of reactive vessels at the interface between the fat and fibrous tissue also contrasted with WDL. Six patients experienced persistent or recurrent lesions within 10 months to 10 years. No aggressive growth or histologic progression was observed during this time, however. Awareness of the features of MLL is important to avoid misclassification of this reactive lesion with WDL.
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C07	`03`	`X`	`ENG`	`@0 Lymphatic vessel disease @5 38`
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C07	`04`	`X`	`FRE`	`@0 Tissu adipeux pathologie @5 45`
C07	`04`	`X`	`ENG`	`@0 Adipose tissue disorders @5 45`
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Format Inist (serveur)

NO :	PASCAL 98-0492971 INIST
ET :	Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma
AU :	FARSHID (G.); WEISS (S. W.)
AF :	Department of Pathology, University of Michigan Hospitals/Ann Arbor, Michigan/Etats-Unis (1 aut., 2 aut.)
DT :	Publication en série; Niveau analytique
SO :	The American journal of surgical pathology; ISSN 0147-5185; Coden AJSPDX; Etats-Unis; Da. 1998; Vol. 22; No. 10; Pp. 1277-1283; Bibl. 4 ref.
LA :	Anglais
EA :	We report 14 cases of a soft tissue lesion in the limbs of morbidly obese adults that presents as a large mass and histologically simulates well-differentiated liposarcoma (WDL). Based on its distinctive clinical setting and morphologic identity to diffuse lymphedema we have termed this process massive localized lymphedema (MLL). All cases occurred in morbidly obese adults (mean weight 372 Ibs; mean age 47 years). Women predominated (9 women: 5 men). The lesions affected the proximal medial aspect of the extremities (12 thigh : 2 arm) and were unilateral in all but two patients. Etiologically significant antecedent events include ipsilateral axillary lymphadenectomy in both patients with arm lesions, chronic lymphedema resulting from vein-stripping 10 years prior in one patient, inguinal lymphadenectomy for anal carcinoma in another patient, and significant blunt trauma to the inner thigh during a motor vehicle accident in a third patient. The tumors were long standing (1-10 years) and extremely large (mean size 33.4 cm. 7408 g). Clinically, they were diffuse, ill-defined masses that histologically consisted of lobules of mature fat interrupted by expanded connective tissue septa. The constituents of the septa were fine, fibrillary collagen, edema fluid, and uniformly distributed fibroblasts. Clusters of capillaries were frequently found at the interface between fat and connective tissue. The widened septa simulated the fibrous bands of sclerosing WDL, but MLL lacks the degree of nuclear atypia seen in the former. The consistent clustering of reactive vessels at the interface between the fat and fibrous tissue also contrasted with WDL. Six patients experienced persistent or recurrent lesions within 10 months to 10 years. No aggressive growth or histologic progression was observed during this time, however. Awareness of the features of MLL is important to avoid misclassification of this reactive lesion with WDL.
CC :	002B08A
FD :	Lymphoedème; Localisé; Membre; Liposarcome; Obésité; Tomodensitométrie; Exploration clinique; Anatomopathologie; Diagnostic différentiel; Etude cas; Adulte; Sarcome; Etat nutritionnel
FG :	Homme; Appareil circulatoire pathologie; Lymphatique pathologie; Tissu adipeux pathologie; Tumeur maligne; Trouble nutrition; Radiodiagnostic; Imagerie médicale
ED :	Lymphedema; Localized; Limb; Liposarcoma; Obesity; Computerized axial tomography; Clinical investigation; Pathology; Differential diagnostic; Case study; Adult; Sarcoma; Nutritional status
EG :	Human; Cardiovascular disease; Lymphatic vessel disease; Adipose tissue disorders; Malignant tumor; Nutrition disorder; Radiodiagnosis; Medical imagery
GD :	Computer Tomographie
SD :	Linfedema; Localizado; Miembro; Liposarcoma; Obesidad; Tomodensitometría; Exploración clínica; Anatomía patológica; Diagnóstico diferencial; Estudio caso; Adulto; Sarcoma; Estado nutricional
LO :	INIST-18344.354000070610300130
ID :	98-0492971

Links to Exploration step

Pascal:98-0492971

Le document en format XML

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<front><div type="abstract" xml:lang="en">We report 14 cases of a soft tissue lesion in the limbs of morbidly obese adults that presents as a large mass and histologically simulates well-differentiated liposarcoma (WDL). Based on its distinctive clinical setting and morphologic identity to diffuse lymphedema we have termed this process massive localized lymphedema (MLL). All cases occurred in morbidly obese adults (mean weight 372 Ibs; mean age 47 years). Women predominated (9 women: 5 men). The lesions affected the proximal medial aspect of the extremities (12 thigh : 2 arm) and were unilateral in all but two patients. Etiologically significant antecedent events include ipsilateral axillary lymphadenectomy in both patients with arm lesions, chronic lymphedema resulting from vein-stripping 10 years prior in one patient, inguinal lymphadenectomy for anal carcinoma in another patient, and significant blunt trauma to the inner thigh during a motor vehicle accident in a third patient. The tumors were long standing (1-10 years) and extremely large (mean size 33.4 cm. 7408 g). Clinically, they were diffuse, ill-defined masses that histologically consisted of lobules of mature fat interrupted by expanded connective tissue septa. The constituents of the septa were fine, fibrillary collagen, edema fluid, and uniformly distributed fibroblasts. Clusters of capillaries were frequently found at the interface between fat and connective tissue. The widened septa simulated the fibrous bands of sclerosing WDL, but MLL lacks the degree of nuclear atypia seen in the former. The consistent clustering of reactive vessels at the interface between the fat and fibrous tissue also contrasted with WDL. Six patients experienced persistent or recurrent lesions within 10 months to 10 years. No aggressive growth or histologic progression was observed during this time, however. Awareness of the features of MLL is important to avoid misclassification of this reactive lesion with WDL.</div>
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<fC03 i1="06" i2="X" l="SPA"><s0>Tomodensitometría</s0>
<s5>10</s5>
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<s5>11</s5>
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<s5>11</s5>
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<s5>38</s5>
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<s5>38</s5>
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<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Tissu adipeux pathologie</s0>
<s5>45</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Adipose tissue disorders</s0>
<s5>45</s5>
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<fC07 i1="04" i2="X" l="SPA"><s0>Tejido adiposo patología</s0>
<s5>45</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Tumeur maligne</s0>
<s5>46</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Malignant tumor</s0>
<s5>46</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Tumor maligno</s0>
<s5>46</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Trouble nutrition</s0>
<s5>53</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Nutrition disorder</s0>
<s5>53</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Trastorno nutricíon</s0>
<s5>53</s5>
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<fC07 i1="07" i2="X" l="FRE"><s0>Radiodiagnostic</s0>
<s5>61</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Radiodiagnosis</s0>
<s5>61</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Radiodiagnóstico</s0>
<s5>61</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Imagerie médicale</s0>
<s5>62</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Medical imagery</s0>
<s5>62</s5>
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<fC07 i1="08" i2="X" l="SPA"><s0>Imageneria medical</s0>
<s5>62</s5>
</fC07>
<fN21><s1>320</s1>
</fN21>
</pA>
</standard>
<server><NO>PASCAL 98-0492971 INIST</NO>
<ET>Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma</ET>
<AU>FARSHID (G.); WEISS (S. W.)</AU>
<AF>Department of Pathology, University of Michigan Hospitals/Ann Arbor, Michigan/Etats-Unis (1 aut., 2 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>The American journal of surgical pathology; ISSN 0147-5185; Coden AJSPDX; Etats-Unis; Da. 1998; Vol. 22; No. 10; Pp. 1277-1283; Bibl. 4 ref.</SO>
<LA>Anglais</LA>
<EA>We report 14 cases of a soft tissue lesion in the limbs of morbidly obese adults that presents as a large mass and histologically simulates well-differentiated liposarcoma (WDL). Based on its distinctive clinical setting and morphologic identity to diffuse lymphedema we have termed this process massive localized lymphedema (MLL). All cases occurred in morbidly obese adults (mean weight 372 Ibs; mean age 47 years). Women predominated (9 women: 5 men). The lesions affected the proximal medial aspect of the extremities (12 thigh : 2 arm) and were unilateral in all but two patients. Etiologically significant antecedent events include ipsilateral axillary lymphadenectomy in both patients with arm lesions, chronic lymphedema resulting from vein-stripping 10 years prior in one patient, inguinal lymphadenectomy for anal carcinoma in another patient, and significant blunt trauma to the inner thigh during a motor vehicle accident in a third patient. The tumors were long standing (1-10 years) and extremely large (mean size 33.4 cm. 7408 g). Clinically, they were diffuse, ill-defined masses that histologically consisted of lobules of mature fat interrupted by expanded connective tissue septa. The constituents of the septa were fine, fibrillary collagen, edema fluid, and uniformly distributed fibroblasts. Clusters of capillaries were frequently found at the interface between fat and connective tissue. The widened septa simulated the fibrous bands of sclerosing WDL, but MLL lacks the degree of nuclear atypia seen in the former. The consistent clustering of reactive vessels at the interface between the fat and fibrous tissue also contrasted with WDL. Six patients experienced persistent or recurrent lesions within 10 months to 10 years. No aggressive growth or histologic progression was observed during this time, however. Awareness of the features of MLL is important to avoid misclassification of this reactive lesion with WDL.</EA>
<CC>002B08A</CC>
<FD>Lymphoedème; Localisé; Membre; Liposarcome; Obésité; Tomodensitométrie; Exploration clinique; Anatomopathologie; Diagnostic différentiel; Etude cas; Adulte; Sarcome; Etat nutritionnel</FD>
<FG>Homme; Appareil circulatoire pathologie; Lymphatique pathologie; Tissu adipeux pathologie; Tumeur maligne; Trouble nutrition; Radiodiagnostic; Imagerie médicale</FG>
<ED>Lymphedema; Localized; Limb; Liposarcoma; Obesity; Computerized axial tomography; Clinical investigation; Pathology; Differential diagnostic; Case study; Adult; Sarcoma; Nutritional status</ED>
<EG>Human; Cardiovascular disease; Lymphatic vessel disease; Adipose tissue disorders; Malignant tumor; Nutrition disorder; Radiodiagnosis; Medical imagery</EG>
<GD>Computer Tomographie</GD>
<SD>Linfedema; Localizado; Miembro; Liposarcoma; Obesidad; Tomodensitometría; Exploración clínica; Anatomía patológica; Diagnóstico diferencial; Estudio caso; Adulto; Sarcoma; Estado nutricional</SD>
<LO>INIST-18344.354000070610300130</LO>
<ID>98-0492971</ID>
</server>
</inist>
</record>

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Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma

Massive localized lymphedema in the morbidly obese : A histologically distinct reactive lesion simulating liposarcoma

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