Mediastinal lipomatosis

Mediastinal lipomatosis is a benign condition characterized by a large amount of mature adipose tissue within the mediastinum. It widens the mediastinum and may simulate mass lesions, thus leading to diagnostic errors. We describe a new case of a huge mediastinal lipomatosis and review 36 cases previously reported in the literature. Computed tomography has an important role in the diagnosis of this disease. To avoid invasive and unnecessary procedures, this diagnosis should be considered in any patient with Cushing's syndrome.     

Parotid lipomatosis

A case of parotid lipomatosis is reported, and the literature is reviewed. This rare condition presents as a slow growing parotid mass, which may be diagnosed preoperatively using computed tomography or magnetic resonance imaging. Long-term clinical follow-up is important because apparently complete surgical excision may be complicated by recurrence.     

Ultrasonography of renal sinus lipomatosis

Gray scale B-scans in renal sinus lipomatosis show a variety of features which must be differentiated from clinically significant pathological processes. Normal kidneys show dense homogeneous central echoes. In renal sinus lipomatosis, however, the central echoes are divided and become more sparse (Type I), interspersed with small relatively echo-free areas (Type II), or outline a single relatively echo-free area resembling a mass (Type III). In contrast to similar features in hydronephrosis or multiple cysts, the relatively echo-free areas in lipomatosis are ill-defined and do present several weak internal echoes.     

Mediastinal lipomatosis in simple obesity

A case of superior mediastinal widening due to unusual amounts of fat accumulations is reported in a patient with simple obesity, not associated with iatrogenic or primary Cushing's syndrome. The radiographic features included a smooth bilateral widening of the superior mediastinum, relative lucency, no definable mass in the lateral view, and no pressure effects on the trachea. Such mediastinal lipomatosis is a benign condition and may be related to general obesity. although rare, it should be considered in the differential diagnosis of mediastinal masses, particularly in obese individuals.     

The radiographic diagnosis of pelvic lipomatosis

Cultured human gastric cancer cell line PAMC82 was studied in vitro to further verify anti-tumor effect sof rare-earth elements and explore their mechanism of tumor inhibition. Inhibitory effects of elements lanthanum and cerium on cell growth, reverse effects of them on reduction of malignancy and effects of them on level of expression of oncogene and cancer suppressor gene were observed. Lanthanum chloride, cerium chloride and mixed rare-earth chloride at levels of 0.5 to 1.5 mmol/L could inhibit obviously growth of cancer cells and change cell morphology and microtubule structure of PAMC82, similar to that of normal cells, their colony-forming ability lowered in soft agar, and expression of tumor suppressor gene p53, p16 and p21 increased and that of gene nm23 lowered.     

Benign symmetrical lipomatosis: Madelung''s disease

The relationship between smoking and bladder cancer risk was investigated using data from a case-control study conducted between January 1994 and July 1996 in Alexandria, Egypt. Cases were 151 males with incident, histologically confirmed invasive cancer of the bladder, and controls were 157 males admitted to hospital for acute, non-neoplastic, non-urinary tract, non-smoking-related conditions. With reference to never smokers, ex-smokers had a multivariate odds ratio (OR) of 4.4 [95% confidence interval (CI) 1.7-11.7] and current smokers of 6.6 (95% CI 3.1-13.9). The ORs were 5.4 for < 20 and 7.6 for > or = 20 cigarettes per day. After adjustment for cigarette smoking, the ORs were 0.8 for waterpipe and 0.4 for hashish smokers. The risk was significantly related to duration of smoking (OR of 16.5 for > 40 years), and inversely related to age at starting (OR of 8.8 for starting < 20 years), and inversely related to time since quitting smoking. Compared with never smokers who did not report a clinical history of schistosomiasis, the OR was 9.4 for smokers with a history of schistosomiasis, and 10.7 for smokers ever employed in high-risk occupations compared with non-smokers not reporting such a history. Thus, our results, while not giving indications of an increased bladder cancer risk with habits other than cigarette smoking, found a remarkably strong association with various measures of cigarette smoking that could explain 75% of bladder cancer cases among males from Alexandria. The prevalence of smoking was very low among women, and consequently tobacco was not a relevant risk factor for female bladder cancer.     

Benign symmetrical lipomatosis. Case report

We present a patient who had benign symmetrical lipomatosis. He was treated surgically (6 operations), and the results were satisfactory. we discuss various factors in this disease and suggest the possibility of a nonsurgical treatment being developed in the future.     

Mitochondrial DNA mutations in multiple symmetric lipomatosis

We describe an analytical technique for measuring residues of imidacloprid, a relatively new and highly active insecticide, in water and soil using high-performance liquid chromatography (HPLC). All analyses were performed on reversed-phase HPLC with UV detection at 270 nm using a mobile phase of acetonitrile-water (20:80, v/v). Fortified water samples were extracted with either solid-phase extraction (SPE) or liquid-liquid extraction methods. A detection limit of 0.5 microgram/l was achieved using the SPE method. The imidacloprid residues in soils were extracted with acetonitrile-water (80:20, v/v), and the extract was then evaporated using a rotary evaporator. The concentrated extract was redissolved in 1 ml of acetonitrile-water (20:80, v/v) prior to analysis by reversed-phase HPLC. A detection limit of 5 micrograms/kg was obtained by this method which is suitable for analysis of environmental samples. Accuracy and precision at 10 and 25 micrograms/kg soil samples were 85 +/- 6% and 82 +/- 4%, respectively.     

Pulmonary lipomatosis: a variant of placental transmogrification

An unusual pulmonary lesion is presented. The patient is a 55-year-old white man with a 2-week history of pleuritic chest pain, shortness of breath, and bronchopneumonia. The patient had also a history of smoking and chronic cough for 12 years. Chest radiographic studies showed a 20-cm bulla in the left upper lobe. A left upper lobectomy was performed obtaining an almost completely collapsed lobe with destruction of the normal architecture by a meshwork of yellowish tissue. Histologically, there were strikingly papillary structures composed almost exclusively of mature adipose tissue with small collections of inflammatory cells. Minimal emphysema in the adjacent lung parenchyma was observed. The case herein presented most likely represents part of the spectrum of placental transmogrification or placentoid bullous lesions of the lung.     

Corticosteroid-induced epidural lipomatosis. Efficacy of medical treatment]

The authors analyse the clinical and therapeutic aspects of myocardial bridges in a series of 6 male patients between the ages of 41 and 61 years. In every cases, the presenting signs were ischaemic order: one myocardial infarction, three cases of unstable angina and two case of stable angina. On coronary angiography, these muscle bridges involved the left anterior descending artery in all cases. The causal relationships between muscle bridges and myocardial ischaemia are discussed. Among the various factors incriminated, spasm, tachycardia and thrombosis appear to play an important role. Depending on the case, treatment modalities consist of beta-blockers, platelet antiaggregants and calcium channel blockers. Surgical treatment is reserved for patients who remain symptomatic despite medical treatment.     

Jejunal lipomatosis with diverticulosis: report of a case

We herein report the very rare case of a 68-year-old Japanese man with multiple jejunal lipomatosis and diverticulosis. He was admitted to our hospital with the chief complaint of melena and anemia. A barium study of the small bowel showed multiple lipomatosis and diverticulosis. An approximately 200-cm length of the jejunum was therefore resected. Thereafter, two diverticula and 215 lipomas were recognized in the resected specimen. A pathological examination showed mature adipose tissue with fibrous septa in the submucosal and muscularis propria. These findings were thus suggested to be due to the attenuation of the muscularis propria. The complications of lipomatosis are also discussed.     

An unusual case of intracranial lipomatosis and cerebral aneurysm

An unusual combination of a fusiform aneurysm on the middle cerebral artery branch to the central region and cortical lipomatosis is described. The etiology of lipomatous disorders in the brain are multiple. The possibility of a combined dysplasia based on maldifferentiation of primitive meninges and the arterial wall is suggested in this case. Treatment consisted in uneventful, microsurgical image-guided resection of the aneurysm using the Surgiscope robotic system.     

Defects of mitochondrial respiratory chain in multiple symmetric lipomatosis

Using lymphocytes from nine unrelated patients with multiple symmetric lipomatosis we investigated a possible defect in the mitochondrial respiratory chain as the biochemical cause for the disease. A significant decrease in oxygen consumption of intact lymphocytes as well as a decreased activity of the individual components of the respiratory chain were detected. These findings are consistent with the recently described deletions and point mutations of mitochondrial DNA in patients suffering from this disease.     

Renal sinus lipomatosis and body composition in hypertensive, obese rabbits

OBJECTIVE: To test whether renal lipomatosis, an accretion of fat in the renal sinus associated with chronic renal infections, abscesses and calculi, can also be caused by rapid weight gain. DESIGN: New Zealand white rabbits were fed either standard rabbit chow (n = 24) or chow fortified with 10% corn oil plus 5% lard (n = 25) for 8-12 weeks. MEASUREMENTS: The rabbits and constituent tissues were weighed initially, after drying and after organic extractions. Renal tissue cholesterol and triglycerides were measured chemically. RESULTS: Rabbits made obese by increased fat intake were 1.8 kg heavier than controls (5.5 +/- 0.3 kg vs 3.7 +/- 0.2; n = 24,25), had 1.54 kg more body fat (1.90 +/- 0.25 vs 0.36 +/- 0.11 kg/rabbit; n = 10,9), and had a mean arterial blood pressure that was 9.2 mm Hg greater than controls (95.1 +/- 8.5 vs 85.9 +/- 5.6 mm Hg; n = 23,24). Individual organs grew in mass (lung, 15%; gastrocnemius, 17%; liver, 27%; kidney, 30%) and their parenchyma gained extractable lipids (lung, 5.5 mg/g tissue; gastrocnemius, 9.6 mg/g tissue; liver, 17.9 mg/g tissue). Total renal triglycerides were increased 2.1 fold, from 103 +/- 36 to 219 +/- 59 mg/kidney (n = 8,8), compared to the 5.3 fold increase in whole body fat. Renal cholesterol was increased 1.7 fold, from 7.5 +/- 1.1 to 12.7 +/- 2.9 mg/kidney, (n = 8,8). Within experimental error, the sum of the total renal triglycerides plus the total renal cholesterol equaled the net fat extracted from the renal sinus alone: 95 +/- 29 mg/kidney in lean rabbits and 253 +/- 71 mg/kidney in obese (n = 17,17). CONCLUSION: Obesity alone can cause renal lipomatosis. This increased volume of anatomically localized fat may be sufficient to externally compress renal veins and lymphatics, thus altering renal hemodynamic behavior.