Skin-nontumor / Clinical Dermatology - Massive localized lymphedema in morbidly obese patients

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Other dermatoses

Massive localized lymphedema in morbidly obese patients

Reviewer: Mowafak Hamodat, MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns, Canada (see Reviewers page)
Revised: 1 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Huge masses in thigh, popliteal fossa, scrotum, suprapubic region, inguinal region and abdomen of morbidly obese patients, lasting 1-8 years
● Clinically resembles lipoma or recurrent cellulitis, but also suspicious for malignancy
● May be due to obstruction of efferent lymphatics by prior surgery, massive abdominal pannus or hypothyroidism

CLinical description
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● Nonencapsulated, poorly defined, mean 51 cm (range 38-75 cm), mean weight 6.8 kg (range 2-12 kg)
● Overlying skin has marbled appearance resembling chronic lymphedema with induration and peau d’orange

Micro description
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● Fibrous bands intersect lobules of adipose tissue
● Lymphatic vascular ectasia, chronic inflammatory infiltrate, edema between collagen fibers, infarction and fat necrosis
● No atypia

Differential diagnosis
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● Sclerosing well differentiated liposarcoma: lipoblasts, atypical stromal cells, atypical adipocytes

Additional references
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● Hum Pathol 2000;31:1162, Am J Surg Pathol 1998;22:1277

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Massive localized lymphedema in morbidly obese patients

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