Nevus lipomatosus cutaneous superficialis

Abstract We report a case of nevus lipomatosus cutaneous superficialis of Hoffman-Zurhelle (NCLS), with multiple lesions, in a ten-year-old child. The NLCS is considered rare. The classical clinical presentation is characterized by multiple skin-colored or yellowish papules and nodules, which can have a linear distribution. Histologically, it is characterized by the presence of mature ectopic adipocytes in the dermis. The main therapeutic option is surgical excision. The classical Nevus lipomatosus cutaneous superficialis is reported in this case.

Lipomas gigantes: série de 14 casos / Giant lipomas: a 14-case series

INTRODUÇÃO: Os lipomas são os tumores mesenquimais benignos mais frequentes na população. Para ser considerado gigante, deve apresentar pelo menos 10 cm em uma de suas dimensões ou pesar ao menos 1.000g. O objetivo do trabalho é analisar uma série de casos de lipomas gigantes atendidos em nosso serviço. MÉTODO: Análise retrospectiva de prontuários e registros anatomopatológicos dos diagnósticos de lipomas submetidos a tratamento cirúrgico no período de janeiro 2003 a janeiro 2010. RESULTADOS: Foram avaliados 14 pacientes, com média de idade de 52,3 anos (33-72) e tempo médio de evolução até o tratamento de 4,4 anos (seis meses - 20 anos); 64% dos casos não apresentavam sintomas. Todos os pacientes foram submetidos à ressecção cirúrgica da neoplasia. O peso médio das peças foi de 3,8 kg (512 g - 22 kg) e o tamanho médio no maior eixo foi de 27,5 cm (15-66 cm). Foram observadas complicações pós-operatórias em 42% dos casos. CONCLUSÃO: Observamos períodos prolongados de evolução até o tratamento, mesmo em casos com lesões de grande volume. A exérese cirúrgica aberta deve ser considerada o tratamento de eleição para estes tumores.

INTRODUCTION: Lipomas are the most common benign mesenchymal tumors worldwide. To be considered giant, they must be at least 10 cm in one of its dimensions or weigh at least 1,000 g. The objective of this study is to analyze a series of cases of giant lipomas seen in our practice. METHOD: We conducted a retrospective analysis of the medical and anatomopathological records of patients diagnosed with lipomas who underwent surgery between January 2003 and January 2010. RESULTS: We evaluated 14 patients with a mean age of 52.3 years (range, 33-72 years) and a mean evolution time until treatment of 4.4 years (range, 6 months to 20 years); 64% of cases presented no symptoms. All patients underwent surgical tumor resection. The average weight of the pieces was 3.8 kg (range, 512 g to 22 kg), while the average length of the longest axis was 27.5 cm (range, 15-66 cm). Postoperative complications were observed in 42% of cases. CONCLUSION: We observed prolonged periods of evolution until treatment, even in cases of large-volume lesions. Open surgical excision should be considered the treatment of choice for these tumors.

Análisis de la viabilidad del adipocito en las distintas fases de la lipotransferencia / Analysis of the feasibility of the adipocyte in the different phases of lipotransfer

Existen numerosas técnicas de lipotransferencia, anterior a la inyección en el huésped, todas ellas proclamadas con gran éxito entre los que las utilizan. La medida de la efi ciencia de estas técnicas fue realizada generalmente sobre la base de experiencias personales y análisis de microscopia directa. Recientemente se han publicado trabajos donde se recalca la importancia del análisis de la viabilidad del adipocito por sobre el conteo de estos, debido a su mayor fi abilidad y a la posibilidad de contar como sanas células grasas que se encuentren en estado de muerte nuclear. El objetivo de este trabajo es realizar un análisis comparativo de la viabilidad del adipocito en distintas etapas del proceso de lipotransferencia, anterior a la reinyección. Material y métodos. Se presentan 15 pacientes, 5 de sexo masculino y 10 de sexo femenino, en los que se realizó la extracción grasa a distintas presiones de vacío. Se analizó la viabilidad del adipocito en distintas fases del procesado: decantación, centrifugación a 500 rpm, centrifugación a 3000 rpm, lavado y tamizado con gasa. Por otro lado, se evaluó su viabilidad en el traspaso de jeringas, en la exposición al aire, en el uso de lidocaína y en su relación con el índice de masa corporal. Resultados. El estudio de la viabilidad demostró que la decantación fue la que mayor sobrevida presentó, seguida por el lavado, tamizado y centrifugación. La lidocaína altera la viabilidad, y el daño también es directamente proporcional a la exposición al aire. Los pacientes con índice de masa corporal (IMC) elevados presentan adipocitos que son más sensibles al manipuleo, por lo que su viabilidad se ve alterada proporcionalmente. El traspaso de jeringas no produce una alteración de la viabilidad signifi cativa. Conclusiones. El decantado es el método que menor daño celular produce seguido por el lavado, tamizado y centrifugado. El daño de la centrifugación es proporcional a la fuerza G generada. La lidocaína, la exposición al aire y el alto IMC infl uyen negativamente sobre la viabilidad del adipocito

Intermuscular lipoma of the submandibular space.

Deep lipomas, especially in the head and neck region, are uncommon. This report describes the case of a patient with a large intermuscular lipoma of the submandibular space, which had been present for 10 years and was diagnosed by computed tomography. The clinical, imaging, and histopathological features, as well as the management of the tumor, are described.

Effects of platelet-rich plasma on healing of alveolar socket: Split-mouth histological and histometric evaluation in Cebus apella monkeys.

Context: The prediction of implant treatment is directly influenced by the quality of the remaining bone after tooth extraction. Aims : The purpose of this experimental study was to, histologically and histometrically, evaluate the bone repair process in the central areas of extraction sockets filled with platelet-rich plasma. Materials and Methods: Four young adult male Cebus apella monkeys were used. The extraction of both right and left inferior second premolars was accomplished. After extraction, in one of the extraction sockets, coagulum was maintained while in the other it was removed; the alveolus was dried with gauze compress and filled up with platelet concentrate. For PRP production, Sonnleitner's protocol was followed. The specimens for histological and histometric assessment were obtained in 30, 90, 120 and 180 days intervals. Results: In 30 days new bone formation was intense in both experimental and control sockets and no significant differences were observed between the two groups. After 90 days of the extraction, while the control group showed signs of decrease in osteogenesis, in the experimental unit, the process of bone formation and fibroblast-like cell proliferation remained intense. After 120 days, the PRP treated socket was occupied by large trabeculae of bone. After 180 days, the control unit was occupied mostly with bone marrow. The experimental unit remained occupied with large amounts of bone tissue. Conclusions: It was possible to conclude that bone repair was enhanced by the use of platelet- rich plasma in alveolar sockets.

Periductal stromal sarcoma of breast with lipoblast-like cells: a case report with review of literature.

The specialized mesenchyme of the breast is the seat of neoplasms with distinct morphology, though with considerable overlap due to the ever increasing number of variants. This article seeks to describe the morphologic features of one such rare neoplasm. A 35-year-old female patient presented with a breast lump that was subsequently excised. Morphological assessment and immunohistochemistry were performed and a diagnosis of periductal stromal sarcoma with lipoblast-like cells (pseudolipoblasts), was made. Being an unusual finding in a rare entity of intermediate grade, it has to be considered, before rendering a diagnosis of a malignant, higher-grade neoplasm.

O tecido adiposo como órgão endócrino: da teoria à prática: [revisão] / Adipose tissue as an endocrine organ: from theory to practice: [review]

OBJETIVOS Mostrar os avanços na pesquisa sobre o papel fisiológico do tecido adiposo branco, ressaltando o seu papel endócrino em processos inflamatórios, no comportamento alimentar, na sensibilização à insulina e na modulação do processo de aterogênese. Abordar o potencial papel do tecido adiposo como fonte de células-tronco para regeneração de tecidos, com especial ênfase para a adipogênese e suas conseqüências para a geração de obesidade. FONTES DE DADOS: Informações importantes constantes da literatura científica foram compiladas de modo a que esta leitura contenha uma síntese esclarecedora dos aspectos mencionados acima. SÍNTESE DOS DADOS:O tecido adiposo possui, além das suas funções clássicas como principal estoque de energia metabólica, suprindo as necessidades energéticas em períodos de carência mediante a lipólise, a capacidade de sintetizar e secretar vários hormônios, as adipocinas. Estas agem em diversos processos, como o controle da ingestão alimentar (leptina) e o controle da sensibilidade à insulina e de processos inflamatórios (TNF-alfa, IL-6, resistina, visfatina, adiponectina). Além disso, como o tecido adiposo contém também células indiferenciadas, tem a habilidade de gerar novos adipócitos, regenerando o próprio tecido (adipogênese), bem como originar outras células (mioblastos, condroblastos, osteoblastos), fato este que tem grande potencial terapêutico em futuro não muito distante. CONCLUSÃO: Amplia-se o leque de possibilidades funcionais do tecido adiposo. A compreensão dessas potencialidades pode fazer deste tecido o grande aliado no combate de moléstias que atualmente vêm assumindo proporções epidêmicas (obesidade, diabetes melito, hipertensão arterial e arteriosclerose), nas quais o tecido adiposo ainda é tido como um grande vilão.

OBJECTIVES: To describe the advances in research into the physiological role of white adipose tissue, with emphasis on its endocrinal role in inflammatory processes, feeding behavior, insulin sensitization and modulation of the atherogenetic process. To deal with the potential role of adipose tissue as a source of stem cells for regeneration of tissues, with special emphasis on adipogenesis and its consequences for development of obesity. SOURCES: Important information was compiled from the scientific literature in order that this analysis contains an explanatory synthesis of the aspects mentioned above. SUMMARY OF THE FINDINGS In addition to its classical functions as primary metabolic energy store, meeting energy requirements during periods of deprivation by means of lypolisis, adipose tissue also has the capacity to synthesize and secrete a variety of hormones - the adipokines. These are active in a range of processes, such as control of nutritional intake (leptin) and control of sensitivity to insulin and inflammatory processes (TNF-alpha, IL-6, resistin, visfatin, adiponectin). Furthermore, since adipose tissue also contains undifferentiated cells, it has the ability to generate new adipocytes, regenerating its own tissue (adipogenesis), and also the ability to give rise to other cells (myoblasts, chondroblasts, osteoblasts), which has great therapeutic potential in the not-too-distant future. CONCLUSIONS: The range of functional possibilities of adipose tissue has widened. An understanding of these potentials could make this tissue a great ally in the fight against conditions that are currently assuming epidemic proportions (obesity, diabetes mellitus, arterial hypertension and arteriosclerosis) and in which adipose tissue is still seen as the enemy.

Inflammatory variant of a well-differentiated retroperitoneal liposarcoma: case report of a rare giant variety.

Inflammatory liposarcoma is a rare variant of a well-differentiated liposarcoma (WDLPS). We present a case of a 37 years old male who had a giant variety of this inflammatory WDLPS. CT scan revealed a large abdomino-pelvic mass abutting the left kidney and pushing the IVC, Aorta and the left ureter across the midline. CT guided FNAC did not reveal any malignant cells. A large 9-kg fibro-fatty mass, which appeared irregular, congested and bosillated was excised. Microscopic picture revealed foci of fibrosis with mature adipose tissue. Lymphocyte and plasma cell infiltrate was abundant along with multi-nucleate giant cells and few lipoblasts. There are no case reports of a giant inflammatory variant of WD-LPS in world literature and this is the first of its kind from the Indian sub-continent. We present a case report of this rare giant variant of inflammatory WDLPS and discuss the review of literature.

Lipomatous metaplasia occurring within meningiomas--two case reports.

Lipomatous meningiomas have recently been described as rare well defined variants of meningiomas characterized by meningothelial cells which undergo a metaplasia to adipocytes. Presence of intratumoral fat can sometimes cause confusion in preoperative radiological diagnosis. We report two such histologically unusual cases of meningiomas with significant adipose tissue metaplasia.

A case of lipomatous hypertrophy of right ventricle.

Lipomatous hypertrophy is a condition that is being increasingly diagnosed with the advent of newer modalities. A middle aged lady was referred to us with recent onset dyspnea and palpitations. Echocardiography revealed diffuse thickening of the right ventricular free wall and outflow tract. Endomyocardial biopsy revealed this as a lipomatous hypertrophy involving the right ventricle. This is the first reported case of lipomatous hypertrophy involving the right ventricle.

Subcutaneous panniculitis-like T cell lymphoma in a HIV positive patient.

Immunocompromised patients are at increased risk for developing certain malignant tumors, particularly aggressive B cell lymphomas and extranodal lymphomas like primary central nervous system lymphoma and primary effusion lymphoma. T cell lymphomas are uncommon in these patients. We report a rare case of subcutaneous panniculitis-like T cell lymphoma in a HIV positive patient who presented with multiple subcutaneous nodules.

Mammary hamartoma--a case report.

Mammary hamartoma is a rare lesion commonly associated with Cowden syndrome. It presents clinically as a fibroadenoma. The nonspecific cytological findings makes the pre-operative diagnosis of this lesion difficult. Though hamartomas of the breast are predominantly benign, co-existent malignancies within them have been reported. These lesions also have a tendency to recur; hence a correct diagnosis and extensive sampling of hamartoma is essential. We report a case of mammary hamartoma with a brief review of literature.

Pleomorphic lipoma of the tonsillar fossa--a case report.

Pleomorphic lipoma is a benign adipocytic tumor, commonly located in the shoulder and posterior neck region. The presence of bizarre, hyperchromatic stromal cells along with multinucleated giant cells often poses difficulty in diagnosis, especially when it arises at an unusual site like tonsillar fossa.

Naevus lipomatosus superficialis: clinicopathological study of a case.

Naevus lipomatosus superficialis is an uncommon skin disorder characterized by the presence of fat cells in the dermis. It is clinically benign and said to be a developmental anomaly. The histological features and the theories of histogenesis have been discussed.

Caso incomum de lipoma associado ao nervo mentoniano: uma revisäo / Unusual case of lipoma associated with the mentoniani nerve: a review

Um caso raro de lipoma intrabucal associado ao nervo mentoniano, causando sintomatologia dolorosa, assim como, uma revisäo de literatura mostrando a discutida etiopatogenia desta alteraçäo é apresentado