Dermatology - diseases of the skin

Lipoma (lipoblastoma, fatty tumor)


Lipoma (lipoblastoma, fatty tumor)

Lipoma (fatty tumor, lipoblastoma, fatty tumor) is a benign neoplasm (tumor) that develops from adipose tissue.

Lipoma is more common in women in the age group from 30 to 50 years. This tumor can be located anywhere where there is fatty tissue in the skin tissue (subcutaneous, intramuscular, perinephric, retroperitoneal), breast, lung, mediastinum (anatomical space in the middle sections of the thoracic cavity bounded by front of the sternum, and posteriorly by the spine), the gastrointestinal tract, myocardium (the muscular middle layer of the heart, comprising the main part of its mass), the meninges, bones, in the course of major nerves. Very rarely, a lipoma can be located in the cranial cavity, uterus and liver.

Depending on the cellular composition of lipomas allocate the following special types:

  • Lipoferum (soft lipoma, represented mainly adipose tissue)
  • Fibrolipoma (dense to the touch lipoma composed of adipose and fibrous connective tissue with a predominance of the latter)
  • Angiolipoma (lipoma with maintaining a large number of blood vessels)
  • Milipore (Wen, containing smooth muscle fibers)
  • Myelolipoma (rare variety in which fatty tissue is a mixture of hematopoietic and can be found in the tissue of retroperitoneum and pelvis, as well as the adrenal glands).

Lipoma (fatty tumor) – pictures and photo

Causes of Lipoma

Causes of lipomaReasons the occurrence of lipomas currently reliably and completely understood. Many scientists believe that the leading factor in the development of lipomas is a violation of embryogenesis (laid before the birth of atypical fat cells subcutaneous fat). It is thought that the occurrence of lipomas may be associated with systemic violation of metabolic (metabolic) processes in adipose tissue. Also, do not exclude the possibility of development of these tumors due to violation of hormonal reactions in the body, which include and menopause in women, when the rearrangement and fertility, and damage to the hypothalamus (the brain) which is responsible for all metabolic processes in the body.

To encourage the development of lipomas can diseases of the pancreas and liver, reduced function of the thyroid gland and pituitary gland (brain appendage in the form of a rounded education that produces hormones that affect growth, metabolism and reproductive function and the Central body of the endocrine system).

Quite often, lipomas occur against a background of alcoholism, diabetes mellitus, malignant neoplasms of the upper respiratory tract. In the medical literature are described familial cases with autosomal dominant inheritance of a subcutaneous lipoma. The increase in the size of lipomas not associated with the General state of the patient: even when exhausted they do not cease to accumulate fat.

About Lipomas

Symptoms of Lipoma

When viewed subcutaneous lipoma is a rounded, movable, not soldered to the surrounding tissues and skin, painless education. When stretching of the skin over the lipoma appear retractions due to the lobular structure of this tumor. Is a lipoma where there is adipose tissue, most often under the skin. The characteristic localization of subcutaneous lipoma – back, upper and lower limbs, head (scalp and face). Quite often a lipoma is multiple.

Symptoms of lipomaThe size of lipomas can vary from the size of a pea to a baby’s head, but typically range from 15 to 50 mm. there are also giant lipomas: such patients the tumor droops, forming in place of its Foundation a thin stalk of skin, which can lead to blood stasis, edema, necrosis and ulceration. Sometimes the size of the tumor due to the body weight of a patient: if you increase the weight of the patient increases in size and a fatty tumor, but more often its growth is uncontrolled, regardless of changes in the body mass.

Usually education has a soft, soft-elastic consistency, and in marked development of connective tissue in it is the seal. In most cases, lipomas are asymptomatic, but sometimes can be painful, cause discomfort, and can also compress nearby organs. Patients mainly complain of a cosmetic defect, especially because with age there is an increase in the size of lipomas.

Lipoma retroperitoneal space can reach quite large sizes. Their clinical manifestations are due to displacement or compression (compression) of nearby organs.

Infiltrating, or intramural, lipoma localized in thicker muscles, while having no clear boundaries.

Multiple small lipomas, which are located along the major nerves, sometimes painful due to the pressure on the corresponding nerve. Diagnosis of deep-lying lip is quite difficult to install it is possible, as a rule, only histological examination.

Examination when Lipoma

Diagnosis surface spaced lip is relatively simple and is based on their location, mjagkoellasticheskih consistency, mobility in relation to the surrounding tissues, painless at palpation and education characteristic of retractions during stretching of the skin over the tumor.
In cases where the lipoma is not available for probing the ground (inside of the chest, pain in the spinal canal), it is necessary to use additional methods research: x-ray and ultrasonography (USG).

1. Radiological diagnosis of soft tissue lipomas is based on the use of long-wavelength (soft) x-ray radiation, which enables the assessment of the soft tissue structures of the body. When x-rays lip, deep-lying, for example, in muscle tissue, it is necessary to increase the “hardness” of the x-ray beam. On radiographs obtained lipoma has a kind of enlightenment, being smooth in outline, usually of regular shape. Is formed by the lipoma of the enlightenment, as a rule, homogeneous, but occasionally it can meet small areas of calcification (deposits in tissue calcium salts). The form of such enlightenment depends on the density of the bodies between which is enclosed a Wen.

When the location of the lipoma in the abdominal cavity, retroperitoneal space or the chest x-ray examination is carried out using the artificial contrasting of gas (create pneumomediastinum, pneumotropica, etc.).

2. The most reliable method of diagnosis of deep lipomas is x-ray computed tomography (CT), allowing to clearly distinguish adipose tissue, which is characterized by low absorption of x-ray radiation from the dense soft tissue structures.

3. Ultrasound examination (ultrasound) lipomas have the appearance of a hypoechoic formations with thin capsule, located in the thickness of adipose tissue.

4. When any doubt as to the benign nature of the tumor resorted to puncture (needle) aspiration biopsy Cytology: using a thin needle to take a fragment of the tumor, and then examine the received biological material under a microscope.

Laboratory tests:

Laboratory examination if the lipoma has no independent value for diagnosis. In case of hospitalization to perform elective surgery on lipoma is General clinical laboratory examination (General analysis of blood (KLA), urinalysis (OAM), biochemical analysis of blood (TANK), blood glucose, HIV testing, syphilis, hepatitis), allowing to exclude contraindications to surgery.

In doubtful cases, to the exclusion of other diseases is cytological examination of material obtained by needle biopsy. To this end obtained by puncture of the material deposited on glass slides then stained by the Giemsa method should turn. Ready drugs the physician-pathologist examines under a microscope. When lipoma biopsy detected in normal fat cells (adipocytes), between which is found a group of cells that contains multiple fat vacuoles.

Treatment of Lipoma

The treatment of lipoma surgery alone. There are the following indications for surgical treatment of lipoma:

  1. Treatment of lipomaRapidly progressive increase in the size of lipomas;
  2. The large size of the lipomas;
  3. Functional disorders, manifested by compression of the surrounding tissues and organs; pain lipoma, impaired organ function;
  4. Cosmetic defect.

When small tumors with available location surgery is performed under local anesthesia in an ambulatory (outpatient) setting. With larger lipomas and lipoma localized in complex anatomical areas (e.g., lipoma neck, axillary fossa), hospitalized patients, and surgical treatment is carried out in a surgical hospital.

When lipomas are three possible surgical intervention:

1. Excision lipoma together with capsule – represents the most radical method of surgical treatment. Under local anesthesia a wide skin incision lipoma velosipedy and is removed together with the capsule, then the sutures in the subcutaneous fatty tissue and skin. In the case of large size of tumors in one or two days, put a drainage bed of excised lipoma. The advantage of this surgical technique is the high efficacy and the absence of recurrence of the tumor, but the drawback is unsatisfactory cosmetic effect.

2. Minimally Invasive (endoscopic) removal of lipomas: through a small skin incision length of 1 cm is the destruction of lipomas and removal inside the capsule, the completeness of removal is by means of minidoka (optical instrument used for the study of hollow anatomical structures). This type of surgery allows to achieve a good cosmetic effect, however, is not sufficiently radical.

3. Liposuction lipoma: through a skin incision of 5 mm in length lipoma inside the capsule is removed with the use of lipoaspirate without further checking on the completeness of its removal. Despite the best cosmetic effect, this surgical technique is fraught with great likelihood of recurrence of lipoma.

The complications of Lipoma

It should be noted that complications are very rare.

  • Inflammation. The tumor becomes red, swells, becomes painful. When pressed on the lipoma felt fluctuation (transmission wave), that is, the presence of fluid in the tumor.
  • In exceptional cases, the lipoma may degenerate into a malignant tumor (liposarcoma).
  • Large, existing for a long time lipoma cause displacement of the surrounding tissues. For example, a lipoma of the peripheral nerves can be the cause of pain, but if it is placed in the preperitoneal tissue, may contribute to hernia white line of the abdomen.

Prevention of Lipomas

Specific preventive measures that may affect the causes of lipomas does not exist.

The effectiveness of treatment of Lipomas

Lipoma a long time may remain unchanged or very slowly increasing in size. Under the influence of trauma or for no apparent reason lipoma can malignization – the nature of malignant tumors (liposarcoma) with invasion into the surrounding tissue.
The forecasts for the treatment of lipomas, usually favorable, although lipomas can recur as on the surgical site, if you have not removed all of the abnormal fat cells and in a new place.