Massive localized lymphedema: a clinicopathologic study of 46 patients with an enrichment for multiplicity.
Identifieur interne : 000B32 ( PubMed/Curation ); précédent : 000B31; suivant : 000B33Massive localized lymphedema: a clinicopathologic study of 46 patients with an enrichment for multiplicity.
Auteurs : Habibe Kurt [États-Unis] ; Christina A. Arnold [États-Unis] ; Jason E. Payne [États-Unis] ; Michael J. Miller [États-Unis] ; Roman J. Skoracki [États-Unis] ; O Hans Iwenofu [États-Unis]Source :
- Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [ 1530-0285 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Calcinose, Lymphoedème, Obésité morbide.
- Adulte, Adulte d'âge moyen, Calcinose, Diagnostic différentiel, Femelle, Humains, Indice de masse corporelle, Jeune adulte, Lymphoedème, Mâle, Obésité morbide, Sujet âgé.
English descriptors
- KwdEn :
- MESH :
- complications : Calcinosis, Lymphedema, Obesity, Morbid.
- pathology : Calcinosis, Lymphedema, Obesity, Morbid.
- Adult, Aged, Body Mass Index, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Young Adult.
Abstract
Massive localized lymphedema is a monstrous tumefactive pseudosarcoma seen in middle-aged morbidly obese adults. Since its initial description in 1998, the etiology remains unknown, although associations with trauma, surgeries, and hypothyroidism have been reported. Herein, we report the largest study of massive localized lymphedema and expand upon its clinicopathologic features. Fifty-four cases from 46 patients were retrospectively identified from the institutional archives of The Ohio State University Wexner Medical Center between 2002 and 2015. Forty-six patients (21 males and 25 females, mean age 50 years) presented with large masses developing over a 5-60-month period. The majority of patients were Caucasian (n=39). All patients were obese with a mean weight of 384.7 lb and a mean body mass index of 59.6 kg/m(2). Thirty-six patients had a history of atherosclerotic cardiovascular disease and diabetes mellitus type 2 was present in 22 patients. Eight patients had multifocal massive localized lymphedema. The sites included thigh (n=33), abdomen (n=17), suprapubic region (n=1), mons pubis (n=6), scrotum (n=2), perianal region (n=1), and right flank (n=1). Mostly, the clinical impression was benign processes, including pannus or lymphedema pseudotumor. Grossly, the mean weight was 8237 g and the mean size was 53.2 cm. Histologically, eight cases showed a unique pattern of dystrophic calcifications mimicking hyperchromatic, atypical nuclei that might lead to misdiagnosis of liposarcoma, four cases showed focal metaplastic ossification, and three cases showed multinucleated cells in addition to prototypic features of massive localized lymphedema. We report that this is the largest series of massive localized lymphedema. This is a lesion mostly seen in morbidly obese patients and the thigh is the most common site of involvement. We note a marked racial predilection for Caucasians and a tendency towards multiplicity. We suggest that obesity itself and the related metabolic syndrome have an important role in its pathogenesis.
DOI: 10.1038/modpathol.2015.135
PubMed: 26585553
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Payne</name><affiliation wicri:level="1"><nlm:affiliation>Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH</wicri:regionArea></affiliation></author><author><name sortKey="Miller, Michael J" sort="Miller, Michael J" uniqKey="Miller M" first="Michael J" last="Miller">Michael J. Miller</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH</wicri:regionArea></affiliation></author><author><name sortKey="Skoracki, Roman J" sort="Skoracki, Roman J" uniqKey="Skoracki R" first="Roman J" last="Skoracki">Roman J. Skoracki</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH</wicri:regionArea></affiliation></author><author><name sortKey="Iwenofu, O Hans" sort="Iwenofu, O Hans" uniqKey="Iwenofu O" first="O Hans" last="Iwenofu">O Hans Iwenofu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH</wicri:regionArea></affiliation></author></analytic><series><title level="j">Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc</title><idno type="eISSN">1530-0285</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Body Mass Index</term><term>Calcinosis (complications)</term><term>Calcinosis (pathology)</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Lymphedema (complications)</term><term>Lymphedema (pathology)</term><term>Male</term><term>Middle Aged</term><term>Obesity, Morbid (complications)</term><term>Obesity, Morbid (pathology)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Calcinose ()</term><term>Calcinose (anatomopathologie)</term><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Jeune adulte</term><term>Lymphoedème ()</term><term>Lymphoedème (anatomopathologie)</term><term>Mâle</term><term>Obésité morbide ()</term><term>Obésité morbide (anatomopathologie)</term><term>Sujet âgé</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Calcinose</term><term>Lymphoedème</term><term>Obésité morbide</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Calcinosis</term><term>Lymphedema</term><term>Obesity, Morbid</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Calcinosis</term><term>Lymphedema</term><term>Obesity, Morbid</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Body Mass Index</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Calcinose</term><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Jeune adulte</term><term>Lymphoedème</term><term>Mâle</term><term>Obésité morbide</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Massive localized lymphedema is a monstrous tumefactive pseudosarcoma seen in middle-aged morbidly obese adults. Since its initial description in 1998, the etiology remains unknown, although associations with trauma, surgeries, and hypothyroidism have been reported. Herein, we report the largest study of massive localized lymphedema and expand upon its clinicopathologic features. Fifty-four cases from 46 patients were retrospectively identified from the institutional archives of The Ohio State University Wexner Medical Center between 2002 and 2015. Forty-six patients (21 males and 25 females, mean age 50 years) presented with large masses developing over a 5-60-month period. The majority of patients were Caucasian (n=39). All patients were obese with a mean weight of 384.7 lb and a mean body mass index of 59.6 kg/m(2). Thirty-six patients had a history of atherosclerotic cardiovascular disease and diabetes mellitus type 2 was present in 22 patients. Eight patients had multifocal massive localized lymphedema. The sites included thigh (n=33), abdomen (n=17), suprapubic region (n=1), mons pubis (n=6), scrotum (n=2), perianal region (n=1), and right flank (n=1). Mostly, the clinical impression was benign processes, including pannus or lymphedema pseudotumor. Grossly, the mean weight was 8237 g and the mean size was 53.2 cm. Histologically, eight cases showed a unique pattern of dystrophic calcifications mimicking hyperchromatic, atypical nuclei that might lead to misdiagnosis of liposarcoma, four cases showed focal metaplastic ossification, and three cases showed multinucleated cells in addition to prototypic features of massive localized lymphedema. We report that this is the largest series of massive localized lymphedema. This is a lesion mostly seen in morbidly obese patients and the thigh is the most common site of involvement. We note a marked racial predilection for Caucasians and a tendency towards multiplicity. We suggest that obesity itself and the related metabolic syndrome have an important role in its pathogenesis.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26585553</PMID><DateCreated><Year>2015</Year><Month>12</Month><Day>30</Day></DateCreated><DateCompleted><Year>2016</Year><Month>10</Month><Day>05</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1530-0285</ISSN><JournalIssue CitedMedium="Internet"><Volume>29</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc</Title><ISOAbbreviation>Mod. Pathol.</ISOAbbreviation></Journal><ArticleTitle>Massive localized lymphedema: a clinicopathologic study of 46 patients with an enrichment for multiplicity.</ArticleTitle><Pagination><MedlinePgn>75-82</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1038/modpathol.2015.135</ELocationID><Abstract><AbstractText>Massive localized lymphedema is a monstrous tumefactive pseudosarcoma seen in middle-aged morbidly obese adults. Since its initial description in 1998, the etiology remains unknown, although associations with trauma, surgeries, and hypothyroidism have been reported. Herein, we report the largest study of massive localized lymphedema and expand upon its clinicopathologic features. Fifty-four cases from 46 patients were retrospectively identified from the institutional archives of The Ohio State University Wexner Medical Center between 2002 and 2015. Forty-six patients (21 males and 25 females, mean age 50 years) presented with large masses developing over a 5-60-month period. The majority of patients were Caucasian (n=39). All patients were obese with a mean weight of 384.7 lb and a mean body mass index of 59.6 kg/m(2). Thirty-six patients had a history of atherosclerotic cardiovascular disease and diabetes mellitus type 2 was present in 22 patients. Eight patients had multifocal massive localized lymphedema. The sites included thigh (n=33), abdomen (n=17), suprapubic region (n=1), mons pubis (n=6), scrotum (n=2), perianal region (n=1), and right flank (n=1). Mostly, the clinical impression was benign processes, including pannus or lymphedema pseudotumor. Grossly, the mean weight was 8237 g and the mean size was 53.2 cm. Histologically, eight cases showed a unique pattern of dystrophic calcifications mimicking hyperchromatic, atypical nuclei that might lead to misdiagnosis of liposarcoma, four cases showed focal metaplastic ossification, and three cases showed multinucleated cells in addition to prototypic features of massive localized lymphedema. We report that this is the largest series of massive localized lymphedema. This is a lesion mostly seen in morbidly obese patients and the thigh is the most common site of involvement. We note a marked racial predilection for Caucasians and a tendency towards multiplicity. We suggest that obesity itself and the related metabolic syndrome have an important role in its pathogenesis.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kurt</LastName><ForeName>Habibe</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, MD Anderson Cancer Center, Houston, TX, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arnold</LastName><ForeName>Christina A</ForeName><Initials>CA</Initials><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Payne</LastName><ForeName>Jason E</ForeName><Initials>JE</Initials><AffiliationInfo><Affiliation>Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Skoracki</LastName><ForeName>Roman J</ForeName><Initials>RJ</Initials><AffiliationInfo><Affiliation>Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Iwenofu</LastName><ForeName>O Hans</ForeName><Initials>OH</Initials><AffiliationInfo><Affiliation>Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>11</Month><Day>20</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mod Pathol</MedlineTA><NlmUniqueID>8806605</NlmUniqueID><ISSNLinking>0893-3952</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Int J Gynecol Pathol. 2011 May;30(3):306-13</RefSource><PMID Version="1">21464721</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Hum Pathol. 2000 Sep;31(9):1162-8</RefSource><PMID Version="1">11014586</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Plast Reconstr Surg. 2000 Dec;106(7):1663-4</RefSource><PMID 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RefType="Cites"><RefSource>Hum Pathol. 2013 Feb;44(2):277-81</RefSource><PMID Version="1">22995331</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015992" MajorTopicYN="N">Body Mass Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002114" MajorTopicYN="N">Calcinosis</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009767" MajorTopicYN="N">Obesity, Morbid</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate 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HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Curation/RBID.i -Sk "pubmed:26585553" \
| HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Curation/biblio.hfd \
| NlmPubMed2Wicri -a LymphedemaV1
| This area was generated with Dilib version V0.6.31. |  |