Esophageal lipomatosis: another consequence of the use of steroids

After we incidentally found on CT extensive esophageal fat accumulations in a patient with long-term use of steroids, we prospectively evaluated during a 6-month period all CT studies of the chest for esophageal lipomatosis and related the findings to the possible use of steroids. The diagnosis of esophageal fat on CT was made by density measurements or if too small for reliable density measurements by comparison with mediastinal fat. In 21 of 1320 exclusively older male patients the diagnosis of esophageal lipomatosis was definite in 7 and likely in 14 patients. All fat accumulations were located in the upper third of the esophagus (mean length 22 ± 6 mm) and presented ring-like (n = 10), irregular (n = 3), or as a horseshoe sparing the posterior border (n = 8). In 20 patients there was an unequivocal history of steroid treatment. Associated centripetal fat infiltration was found in 11 patients. None of the patients had swallowing problems. Prolonged use of steroids, either orally or inhalationally administered, is associated with esophageal lipomatosis. The predisposition for the upper esophagus might be related to the presence of striated muscle cells in this part of the esophagus; moreover, inhalational steroid therapy may adversely affect the upper esophagus. Received: 3 April 2000; Accepted: 2 May 2000     

MERRF syndrome (Myoclonic Epilepsy with Ragged Red Fibres) presenting with cervicothoracic lipomatosis

Introduction

Patients with MERRF syndrome (Myoclonic Epilepsy with Ragged Red Fibres) usually present with encephalomyopathy. However, progressive, recurrent cervicothoracic lipomatosis may be rarely observed.

良性对称性脂肪瘤病28例报告

目的:探讨良性对称性脂肪瘤病的临床特点,提高诊断和治疗水平。方法:对经治的28例良性对称性脂肪瘤病的临床资料,结合文献进行分析。28例均行手术治疗。结果:28例术后无一例出现手术并发症或死亡,功能和外形均恢复正常。随访2～15年,平均6年5个月,5例复发。结论:良性对称性脂肪瘤多见于中年男性,具有典型的颈部肿块弥漫性对称性分布和“驼峰背”样外形。病因可能与嗜酒有关;手术是最有效的治疗方法,但以美容整形为主。故不宜过于强调手术彻底性,以免损伤颈部重要结构。     

Uneven Lipomatosis: A pitfall in pancreatic Sonography

A marked difference in echogenicity between the anterior and posterior parts of the pancreatic head was demonstrated by pancreatic ultrasound in 4 patients. This finding could not be related to local pancreatic or peripancreatic pathology. In all patients the dorsal portion of the head, including the uncinate process, appeared less echogenic than the ventral part of the head, body, and tail. The level of demarcation was identical in all 4 cases, coinciding with the expected fusion line of the embryological dorsal and ventral pancreatic origin. Pathology available in 1 patient showed an uneven lipomatosis as an explanation for this hitherto unreported observation.     

Infantile congenital parotid lipomatosis: a rare case report

A case of congenital parotid lipomatosis in an infant is reported and literature is reviewed. This rare condition in children presents as gradually increasing parotid swelling, which is difficult to diagnose preoperatively as this condition is not considered in the differential diagnosis of a parotid mass. Complete excision with superficial or total parotidectomy with preservation of facial nerve is the treatment of choice.     

盆腔脂肪增多症的诊断和治疗

目的：探讨盆腔脂肪增多症的诊断和治疗方法。方法：回顾性分析我院5例盆腔脂肪增多症患者诊断和治疗的临床资料，并复习文献就本病的临床特点进行分析。结果：5例患者均经影像学和病理检查确诊。3例患者行手术治疗而获痊愈，随访至今效果良好；1例患者行双肾穿刺造瘘术后症状缓解，现仍生存；1例患者自动出院失访。结论：盆腔脂肪增多症在影像学上有其特征性的表现，是其诊断的主要依据。手术彻底清除异常增生的脂肪是首选的治疗方法。     

Renal replacement lipomatosis: ultrasonography and computed tomography findings

Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. The diagnosis is difficult to establish with conventional radiographic methods. Although ultrasonography may show highly suggestive findings, computed tomography seems to be the most accurate method for demonstrating the distinctive features of replacement lipomatosis. Ultrasonographic and computed tomographic features in three cases of replacement lipomatosis of the kidney are reported. Received: 19 October 1998; Revision received: 8 December 1998; Accepted: 6 January 1999     

Compression médullaire lente par lipomatose épidurale thoracique idiopathique : cas clinique et revue de la littérature

We report the case of a patient with spinal cord compression evolving over 36 months with spastic paraparesis. Anatomic imagery showed epidural lipomatosis. No predisposing factors were found. Surgical treatment was decided. A T1-T10 laminectomy with excision of the surplus epidural fat was performed. Immediate and medium-term postsurgical follow-up was favorable with the disappearance of the pyramidal syndrome. Other cases found in literature and the principal predisposing factors are discussed.     

特发性椎管内硬膜外脂肪增多症的MRI与临床诊断

目的：探讨特发性椎管内硬膜外脂肪增多症的MRI与临床表现。方法：收集特发性椎管内硬膜外脂肪增多症12例。回顾性分析术前MRI及其它影像表现。结果：特发性椎管内硬膜外脂肪增多症的MRI表现有以下特征：（1）椎管内背侧硬膜外过多的脂肪沉积。（2）沉积的脂肪呈连续的棱带状。（3）硬膜囊背侧受压。（4）脊髓受压,所作X线检查椎管内未见异常,部分脊髓造影示通过不畅。所作CT检查可见过多沉积的脂肪,但不能显示脊髓的受压等表现。结论：特发性椎管内硬膜外脂肪增多症的MRI在病灶的部位、形态、信号及其对周围组织的影响等方面均有规律可循,且MRI优于其它影像学检查,为临床诊断及治疗提供依据。