Massive Localized Lymphedema Arising from Abdominal Wall: A Case Report and Review of the Literature
Identifieur interne : 003D12 ( Pmc/Curation ); précédent : 003D11; suivant : 003D13Massive Localized Lymphedema Arising from Abdominal Wall: A Case Report and Review of the Literature
Auteurs : Teod Ra T Th [Hongrie] ; Yi-Che Chang Chien [Hongrie] ; Sándor Kollár [Hongrie] ; Ilona Kovács [Hongrie]Source :
- Case Reports in Pathology [ 2090-6781 ] ; 2015.
Abstract
Massive localized lymphedema (MLL) is a rare pseudosarcomatous lesion due to localized lymphatic obstruction from variable causes. It is most common on medial aspect of thigh and inguinal region. Abdominal localization is rare and may cause clinical diagnostic confusion with other malignant tumors due to its large size. We report a case of abdominal wall MLL of a 56-year-old male patient under clinical suspicion of well differentiated liposarcoma. The literature search and differential diagnosis will be addressed. In doubt cases, immunohistochemical stain or fluorescent in situ hybridization can help to separate this entity from the other mimickers.
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DOI: 10.1155/2015/375090
PubMed: 26417468
PubMed Central: 4568386
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first="Teod Ra" last="T Th">Teod Ra T Th</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031, Hungary</nlm:aff><country xml:lang="fr">Hongrie</country><wicri:regionArea>Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031</wicri:regionArea></affiliation></author><author><name sortKey="Chang Chien, Yi Che" sort="Chang Chien, Yi Che" uniqKey="Chang Chien Y" first="Yi-Che" last="Chang Chien">Yi-Che Chang Chien</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031, Hungary</nlm:aff><country xml:lang="fr">Hongrie</country><wicri:regionArea>Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031</wicri:regionArea></affiliation></author><author><name sortKey="Kollar, Sandor" sort="Kollar, Sandor" uniqKey="Kollar S" first="Sándor" last="Kollár">Sándor Kollár</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031, Hungary</nlm:aff><country xml:lang="fr">Hongrie</country><wicri:regionArea>Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031</wicri:regionArea></affiliation></author><author><name sortKey="Kovacs, Ilona" sort="Kovacs, Ilona" uniqKey="Kovacs I" first="Ilona" last="Kovács">Ilona Kovács</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031, Hungary</nlm:aff><country xml:lang="fr">Hongrie</country><wicri:regionArea>Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031</wicri:regionArea></affiliation></author></analytic><series><title level="j">Case Reports in Pathology</title><idno type="ISSN">2090-6781</idno><idno type="eISSN">2090-679X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Massive localized lymphedema (MLL) is a rare pseudosarcomatous lesion due to localized lymphatic obstruction from variable causes. It is most common on medial aspect of thigh and inguinal region. Abdominal localization is rare and may cause clinical diagnostic confusion with other malignant tumors due to its large size. We report a case of abdominal wall MLL of a 56-year-old male patient under clinical suspicion of well differentiated liposarcoma. The literature search and differential diagnosis will be addressed. In doubt cases, immunohistochemical stain or fluorescent in situ hybridization can help to separate this entity from the other mimickers.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Manduch, M" uniqKey="Manduch M">M. Manduch</name></author><author><name sortKey="Oliveira, A M" uniqKey="Oliveira A">A. M. Oliveira</name></author><author><name sortKey="Nascimento, A G" uniqKey="Nascimento A">A. G. Nascimento</name></author><author><name sortKey="Folpe, A L" uniqKey="Folpe A">A. L. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Pathol</journal-id><journal-id journal-id-type="iso-abbrev">Case Rep Pathol</journal-id><journal-id journal-id-type="publisher-id">CRIPA</journal-id><journal-title-group><journal-title>Case Reports in Pathology</journal-title></journal-title-group><issn pub-type="ppub">2090-6781</issn><issn pub-type="epub">2090-679X</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26417468</article-id><article-id pub-id-type="pmc">4568386</article-id><article-id pub-id-type="doi">10.1155/2015/375090</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Massive Localized Lymphedema Arising from Abdominal Wall: A Case Report and Review of the Literature</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Tóth</surname><given-names>Teodóra</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><name><surname>Chang Chien</surname><given-names>Yi-Che</given-names></name><xref ref-type="aff" rid="I1"></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kollár</surname><given-names>Sándor</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><name><surname>Kovács</surname><given-names>Ilona</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib></contrib-group><aff id="I1">Department of Pathology, Kenézy Gyula County Hospital, Bartók Béla út 2-26, Debrecen 4031, Hungary</aff><author-notes><corresp id="cor1">*Yi-Che Chang Chien: <email>ccwilly@hotmail.com</email></corresp><fn fn-type="other"><p>Academic Editor: Khin Thway</p></fn></author-notes><pub-date pub-type="ppub"><year>2015</year></pub-date><pub-date pub-type="epub"><day>31</day><month>8</month><year>2015</year></pub-date><volume>2015</volume><elocation-id>375090</elocation-id><history><date date-type="received"><day>25</day><month>5</month><year>2015</year></date><date date-type="rev-recd"><day>10</day><month>8</month><year>2015</year></date><date date-type="accepted"><day>26</day><month>8</month><year>2015</year></date></history><permissions><copyright-statement>Copyright © 2015 Teodóra Tóth et al.</copyright-statement><copyright-year>2015</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Massive localized lymphedema (MLL) is a rare pseudosarcomatous lesion due to localized lymphatic obstruction from variable causes. It is most common on medial aspect of thigh and inguinal region. Abdominal localization is rare and may cause clinical diagnostic confusion with other malignant tumors due to its large size. We report a case of abdominal wall MLL of a 56-year-old male patient under clinical suspicion of well differentiated liposarcoma. The literature search and differential diagnosis will be addressed. In doubt cases, immunohistochemical stain or fluorescent in situ hybridization can help to separate this entity from the other mimickers.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Macroscopic characteristics of MLL. The skin is indurated and hyperpigmented with classical “peau d'orange” appearance (a). The cut surface revealed the thickened skin (b). The subcutaneous tissue cut surface showed serous fluid (indicated by “<italic>∗</italic>”) and also lobulated proliferation of fatty tissue (c) partially surround by thickened fibrous bands ((d), indicated by “<italic>∗</italic>”). Focal dilated, thrombotised vessels were also noted (e).</p></caption><graphic xlink:href="CRIPA2015-375090.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Histomorphology of MLL. The epidermis showed mild acanthosis, elongated rete ridges, basal melanocytic proliferation, and hyperpigmentation ((a), 20x). The dermis revealed reactive lobular vascular proliferation with congestion and mild lymphocytic infiltration similar to stasis dermatitis ((b), 10x). The subcutaneous areas show adipose tissue and reactive vascular proliferation ((c), 20x) and reactive fibroblasts ((d), 40x).</p></caption><graphic xlink:href="CRIPA2015-375090.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Reactive lobular vascular proliferation, highlighted by CD31 ((a), 10x). The stromal cells are positive for vimentin ((b), 20x) and negative for S-100, MDM2, and p16 ((c)–(e), all 20x).</p></caption><graphic xlink:href="CRIPA2015-375090.003"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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