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Lipoma

Lipoma - a benign tumor of fatty tissue.

Lipoma epidemiology

The lipoma occurs at any age, a thicket at women, growth slow, can reach the considerable sizes.

Classification

Multiple lipomatoz has 3 versions:
• Derkum's (lipomatosis dolorosa) illness;
• high-quality symmetric lipomatoz, or illness of Madelunga;
• family lipomatoz.

Etiology and pathogeny

The important part in development of a lipoma is assigned to the metabolic changes caused by insufficiency of regulatory proteins-enzymes.
Family lipomatoz it is inherited on autosomal dominantly type and shown at young age.

Clinical signs and symptoms

The tumor is shown by single or multiple hypodermic nodes, roundish or lobular, a myagkoelastichesky consistence, as a rule, not soldered to skin. At a multiple symmetric lipomatoz the centers large, merging among themselves, an elastic consistence, localized more often on a neck, in occipital area, upper part of a trunk and proximal departments of extremities.

The diagnosis and the recommended clinical trials

Statement of the diagnosis requires cytologic research of punctate.
Microscopically the tumor is constructed as usual fatty tissue and differs from it in the sizes of segments and lipoblasts. The last either are very small, or reach the huge sizes. In certain cases between segments and separate lipoblasts there is a growth of connecting fabric, sometimes considerable, the fibrolipoma is formed. In the presence in it a large number of vessels the tumor is called an angiolipoma.
At an illness Derkuma the histologic picture is often similar described above, however the structure of an angiolipoma or a granulematozny structure with existence of colossal cells of foreign bodys is in certain cases observed.
At a high-quality symmetric lipomatoz and family multiple the General principles of treatment a multicentric lipomatoz nodes have structure of a usual lipoma. At a system form of a multiple lipomatoz except mature lipoblasts find the undifferentiated mesenchymal, and also intermediate cells containing various quantity of lipids in the cytoplasm.

In well differentiated sites the mature lipoblasts which are usually located in a mucoid stroma in less differentiated zones are visible there are lipoblasts of various degree of a maturity containing lipids, and also the sites consisting of fibroblastichesky elements.

Differential diagnosis

Neurofibromatosis, liposarcoma.

Surgical excision of solitary educations is shown.

Forecast

Favorable.
 
"Skin lymphoma   Valdenstrem's macroglobulinemia"