LIPOMA (Definition - Pathology - Clinical Picture

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LIPOMA (Definition - Pathology - Clinical Picture - Treatment )

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Thursday, 10 December 2009 20:52

Definition: It is acommon tumour composed of adult fat cells.
Sites: Any sites containing fat common in back, shoulder & buttocks.
Pathology:
Well capsulated swelling but the capsule may send fibrous strands into the fatty tissue leading to lobulation of the mass.
1- Pure lipoma.
2- Fibro lipoma (Fibrous tissues is marked).
3- Angio lipoma (Partially compressible) e.g. in parotid gland.
4- False lipomas (aggregated fatty tissues in certain area as in Cushing' disease). In Dercum 's disease: Multiple painful lipomas (Lipoma dolorosa) are found in fatty woman. Usually in her thighs.
Clinical picture:
It occures either subcutaneous or subfascial or not rarely inter muscular, subperiosteal, subserous submucous and retroperitoneal.
1- The subcutaneous lipomas are soft swelling showing pseudo fluctuation with lobulated surface. It is freely mobile from underlying tissues but it may be attached to skin by fibrous strands  Dimpling in skin when pinching. It has a slippery edge.
2- The subfascial lipoma may be firm with out lobulation so it is difficult to diagnose.
3- Calcification and infection may complicate alipoma.
 The dangerous lipomas are: "Which may kill the patient"
1- Lipoma changed into liposarcoma (in shoulder & retroperitoneum).
2- Submucous Lipoma of intestine  intussusception.
3- Subthecal lipoma may compress the cord  Paraplegia.
4- Pedunculated lipoma may undergo torsion  severe intestinal bleeding.
Treatment:
1- Excision by incising the capsule and shelling it out.
SOURCE: Prof. AYMAN SALEM'S BOOK
Copyright: (Vascular Society of Egypt ) & (Medical Educational web)
Not to be reproduced without permission of Vascular Society of Egypt

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