Abstract
Three morbidly obese women were referred to us with suspected soft-tissue sarcomas. All lesions arose from the medial subcutaneous tissues of the thigh, and were shown to represent massive localised lymphoedema (MLL), a rare condition occurring in morbidly obese adults. MR imaging typically demonstrates a sharply demarcated, pedunculated mass consisting of fat partitioned by fibrous septae surrounded by a thickened dermis. There is oedema both within the mass and tracking along the subcutaneous septae in a “lace-like” fashion outwards from the pedicle, outlining large lobules of fat. Minimal enhancement is observed within the dermis of the lesion following intravenous gadolinium administration. Obesity is a growing problem that is likely to result in an increase in the prevalence of this condition; therefore, familiarity with the radiological appearance is important in establishing a correct diagnosis in this condition that may mimic a soft-tissue sarcoma.
References
Farshid G, Weiss SW. Massive localized lymphedema in the morbidly obese: a histologically distinct reactive lesion simulating liposarcoma. Am J Surg Pathol. 1998;22(10):1277–83.
Wu D, Gibbs J, Corral D, Intengan M, Brooks JJ. Massive localized lymphedema: additional locations and association with hypothyroidism. Hum Pathol. 2000;31(9):1162–8.
Berenji M, Kalani A, Kim J, Kelly K, Wallack MK. Massive localized lymphedema of the thigh in a morbidly obese patient. Eur J Surg Oncol. 2010;36(1):104–6.
Manduch M, Oliveira AM, Nascimento AG, Folpe AL. Massive localised lymphoedema: a clinicopathological study of 22 cases and review of the literature. J Clin Pathol. 2009;62(9):808–11.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Khanna, M., Naraghi, A.M., Salonen, D. et al. Massive localised lymphoedema: clinical presentation and MR imaging characteristics. Skeletal Radiol 40, 647–652 (2011). https://doi.org/10.1007/s00256-010-1080-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-010-1080-4