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Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.

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Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.

Auteurs : Stephen Lee [États-Unis] ; Jeong S. Han ; Hillary M. Ross ; Jonathan I. Epstein

Source :

Human pathology [ 1532-8392 ] ; 2013.

RBID : pubmed:22995331

Descripteurs français

KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Cellules stromales (anatomopathologie), Humains, Indice de masse corporelle, Lymphoedème (anatomopathologie), Maladies de l'appareil génital mâle (anatomopathologie), Mâle, Obésité morbide (), Pénis (anatomopathologie), Scrotum (anatomopathologie), Sujet âgé, Tissu adipeux, Études de suivi, Études rétrospectives.
MESH :
- anatomopathologie : Cellules stromales, Lymphoedème, Maladies de l'appareil génital mâle, Pénis, Scrotum.
- Adolescent, Adulte, Adulte d'âge moyen, Humains, Indice de masse corporelle, Mâle, Obésité morbide, Sujet âgé, Tissu adipeux, Études de suivi, Études rétrospectives.

English descriptors

KwdEn :
- Adipose Tissue, Adolescent, Adult, Aged, Body Mass Index, Follow-Up Studies, Genital Diseases, Male (pathology), Humans, Lymphedema (pathology), Male, Middle Aged, Obesity, Morbid (complications), Penis (pathology), Retrospective Studies, Scrotum (pathology), Stromal Cells (pathology).
MESH :
- complications : Obesity, Morbid.
- pathology : Genital Diseases, Male, Lymphedema, Penis, Scrotum, Stromal Cells.
- Adipose Tissue, Adolescent, Adult, Aged, Body Mass Index, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies.

Abstract

Massive localized lymphedema is a reactive pseudotumor strongly associated with obesity. The tumor most commonly presents as pendulous masses in the lower limbs with only 3 reported cases involving external male genitalia. In this study, we report an additional 6 cases localized to the external male genitalia. The cases were retrospectively identified from the surgical pathology database of the Johns Hopkins Hospital. All 6 patients were obese (5 presented with diffuse scrotal edema and 1 with a penile mass). In all cases, the clinical impression was of a benign chronic process developing over 3 months to 1 year. All 3 cases from outside institutions were referred with benign pathologic diagnoses. The lesions ranged in size from 4 to 55 cm. Microscopically, all cases exhibited stromal fibrosis and edema, multinucleated stromal cells, perivascular chronic inflammation, and lymphangiectasia. Entrapped fat was a minor feature and seen in only 3 cases. Variable hyperplasia and hypertrophy of dartos muscle were noted in 6 lesions. Three cases showed prominent microvascular proliferation around the edge of individual dartos muscle bundles. In summary, diagnosis of massive localized lymphedema requires appropriate correlation between clinical and microscopic findings. Lesions in the male external genitalia share many microscopic findings with massive localized lymphedema at other sites, although entrapped adipose tissue is not prominent. Additional, although not specific, findings include variably hyperplastic and hypertrophic dartos muscle and capillary neoangiogenesis at the interface between smooth muscle bundles and stroma.

DOI: 10.1016/j.humpath.2012.05.023
PubMed: 22995331

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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD 21287</wicri:regionArea>
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<author><name sortKey="Epstein, Jonathan I" sort="Epstein, Jonathan I" uniqKey="Epstein J" first="Jonathan I" last="Epstein">Jonathan I. Epstein</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adipose Tissue</term>
<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Body Mass Index</term>
<term>Follow-Up Studies</term>
<term>Genital Diseases, Male (pathology)</term>
<term>Humans</term>
<term>Lymphedema (pathology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Obesity, Morbid (complications)</term>
<term>Penis (pathology)</term>
<term>Retrospective Studies</term>
<term>Scrotum (pathology)</term>
<term>Stromal Cells (pathology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Cellules stromales (anatomopathologie)</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Lymphoedème (anatomopathologie)</term>
<term>Maladies de l'appareil génital mâle (anatomopathologie)</term>
<term>Mâle</term>
<term>Obésité morbide ()</term>
<term>Pénis (anatomopathologie)</term>
<term>Scrotum (anatomopathologie)</term>
<term>Sujet âgé</term>
<term>Tissu adipeux</term>
<term>Études de suivi</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Cellules stromales</term>
<term>Lymphoedème</term>
<term>Maladies de l'appareil génital mâle</term>
<term>Pénis</term>
<term>Scrotum</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Obesity, Morbid</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Genital Diseases, Male</term>
<term>Lymphedema</term>
<term>Penis</term>
<term>Scrotum</term>
<term>Stromal Cells</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adipose Tissue</term>
<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Body Mass Index</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Mâle</term>
<term>Obésité morbide</term>
<term>Sujet âgé</term>
<term>Tissu adipeux</term>
<term>Études de suivi</term>
<term>Études rétrospectives</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Massive localized lymphedema is a reactive pseudotumor strongly associated with obesity. The tumor most commonly presents as pendulous masses in the lower limbs with only 3 reported cases involving external male genitalia. In this study, we report an additional 6 cases localized to the external male genitalia. The cases were retrospectively identified from the surgical pathology database of the Johns Hopkins Hospital. All 6 patients were obese (5 presented with diffuse scrotal edema and 1 with a penile mass). In all cases, the clinical impression was of a benign chronic process developing over 3 months to 1 year. All 3 cases from outside institutions were referred with benign pathologic diagnoses. The lesions ranged in size from 4 to 55 cm. Microscopically, all cases exhibited stromal fibrosis and edema, multinucleated stromal cells, perivascular chronic inflammation, and lymphangiectasia. Entrapped fat was a minor feature and seen in only 3 cases. Variable hyperplasia and hypertrophy of dartos muscle were noted in 6 lesions. Three cases showed prominent microvascular proliferation around the edge of individual dartos muscle bundles. In summary, diagnosis of massive localized lymphedema requires appropriate correlation between clinical and microscopic findings. Lesions in the male external genitalia share many microscopic findings with massive localized lymphedema at other sites, although entrapped adipose tissue is not prominent. Additional, although not specific, findings include variably hyperplastic and hypertrophic dartos muscle and capillary neoangiogenesis at the interface between smooth muscle bundles and stroma.</div>
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<ArticleTitle>Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.</ArticleTitle>
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<Abstract><AbstractText>Massive localized lymphedema is a reactive pseudotumor strongly associated with obesity. The tumor most commonly presents as pendulous masses in the lower limbs with only 3 reported cases involving external male genitalia. In this study, we report an additional 6 cases localized to the external male genitalia. The cases were retrospectively identified from the surgical pathology database of the Johns Hopkins Hospital. All 6 patients were obese (5 presented with diffuse scrotal edema and 1 with a penile mass). In all cases, the clinical impression was of a benign chronic process developing over 3 months to 1 year. All 3 cases from outside institutions were referred with benign pathologic diagnoses. The lesions ranged in size from 4 to 55 cm. Microscopically, all cases exhibited stromal fibrosis and edema, multinucleated stromal cells, perivascular chronic inflammation, and lymphangiectasia. Entrapped fat was a minor feature and seen in only 3 cases. Variable hyperplasia and hypertrophy of dartos muscle were noted in 6 lesions. Three cases showed prominent microvascular proliferation around the edge of individual dartos muscle bundles. In summary, diagnosis of massive localized lymphedema requires appropriate correlation between clinical and microscopic findings. Lesions in the male external genitalia share many microscopic findings with massive localized lymphedema at other sites, although entrapped adipose tissue is not prominent. Additional, although not specific, findings include variably hyperplastic and hypertrophic dartos muscle and capillary neoangiogenesis at the interface between smooth muscle bundles and stroma.</AbstractText>
<CopyrightInformation>Copyright © 2013 Elsevier Inc. All rights reserved.</CopyrightInformation>
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<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
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Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.

Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.

Source :

Descripteurs français

English descriptors

Abstract

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