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Lipomatosis is a condition where there is diffuse excessive fat deposition within the body. Although considered a single entity in the WHO classification of soft tissue and bone tumors 7, lipomatosis encompasses a variety of conditions heterogeneous in demographics, distribution and etiology. These are, therefore, discussed separately (see below).
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Importantly many of the conditions that have an abnormal accumulation of fat in certain regions (lipomatosis) can also have a simultaneous loss of fat in other regions (lipodystrophy); HIV-associated lipodystrophy is a good example.
neck and upper region of the trunk
abdomen and pelvis
abdomen: diffuse intraabdominal lipomatosis
retroperitoneum: retroperitoneal lipomatosis 1-2
pelvis: pelvic lipomatosis
pancreas: pancreatic lipomatosis
ileocecal valve: lipomatosis of the ileocecal valve
colon: colonic lipomatosis 6
epidural space: epidural lipomatosis
Lipomatosis, regardless of cause, is characterized histologically by mature adipocytes arranged in lobules and sheets 7.
Treatment and prognosis
In many instances, no treatment is required, or the underlying cause can be treated (e.g. Cushing syndrome). When pronounced or of cosmetic concern, surgical removal can be performed although recurrence is common 7.
Occasionally, if extensive, the accumulation of fat can cause mechanical compression and result in regional symptoms which will depend on the location (e.g. nerve root/cauda equina compression or laryngeal compression).
Possible imaging differential considerations include:
lipoma: "distinct" fat-containing lesion
low grade diffuse fat series tumor
- 1. Bryk D, Young RS, Morris N. Retroperitoneal lipomatosis-report of two cases with an unusual distribution. Gastrointest Radiol. 1979;4 (3): 309-12. Pubmed citation
- 2. Craig WD, Fanburg-Smith JC, Henry LR et-al. Fat-containing lesions of the retroperitoneum: radiologic-pathologic correlation. Radiographics. 2009;29 (1): 261-90. Radiographics (full text) - doi:10.1148/rg.291085203 - Pubmed citation
- 3. Murphey MD, Carroll JF, Flemming DJ et-al. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics. 2004;24 (5): 1433-66. Radiographics (full text) - doi:10.1148/rg.245045120 - Pubmed citation
- 4. Yesilkaya Y, Duymus M, Topcuoglu M. Pelvic lipomatosis: US and CT diagnosis. Biomed Imaging Interv J. 2012;8 (2): e12. Free text at pubmed - Pubmed citation
- 5. Watt A, McMillan N. Clinical Radiology. 1999;54 (11): . doi:10.1016/S0009-9260(99)91185-6
- 6. Catania G, Petralia GA, Migliore M, Cardì F. Diffuse colonic lipomatosis with giant hypertrophy of the epiploic appendices and diverticulosis of the colon. Report of a case and review of the literature. Diseases of the colon and rectum. 38 (7): 769-75. Pubmed
- 7. Folpe A, Rosenberg A, Nielsen G, Lipomatosis. In: WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours. Lyon (France): International Agency for Research on Cancer; 2020. (WHO classification of tumours series, 5th ed.; vol. 3). https://publications.iarc.fr