LIPOMA: UNIVERSAL TUMOUR

Lipoma is a benign tumour arising from fat cells of adult type. It is also called 'universal tumour' because it can occur anywhere in the body where there is fat.

DIAGNOSTIC FEATURES OF LIPOMA

• Subcutaneous-commonest type

• Soft to firm lobular swelling

• 'Slip' sign positive-a pathognomonic sign

• Semifluctuant swelling

• 'Smart' dimple sign on movement of the skin

Overview

• The swelling is soft, may feel cystic with fluctuation. This is also called pseudofluctuation because fat at body temperature behaves like fluid.

• Surface is lobular. Lobulations are better appreciated with firm palpation of the swelling. Due to the pressure, lobules bulge out between the fibrous tissue strands.

• The edge slips under the palpating finger which is a pathognomonic sign of Lipoma.

Types

1. Single encapsulated lipoma

• This is a single, soft, slow-growing, painless and semifluctuant swelling.

• Commonly present as a subcutaneous swelling. It is freely mobile. The flank is the commonest site. Shoulder region, neck, back, upper limbs are the other common sites. Some lipomas from the chest wall can be of large size.

• Dimpling sign: Fibrous bands connect a lipoma to the skin. When the skin moved, a dimple appears on the skin.

2. Multiple lipomatosis

• Such lipomas are multiple and very often tender because of nerve elements mixed with them. Hence, they are called multiple neurolipomatosis. Dercum s disease is one example of this variety (Adiposis dolorosa) wherein tender, lipomatous swellings are present in the body, mainly the trunk.

3. Uncapsulated lipoma (diffuse)

• Diffuse variety is a rare type of lipoma. It is called pseudolipoma. It is an overgrowth of fat without a capsule.

Histological types of lipoma

1. Fibrolipoma: Since fibrous tissue is mixed with fat, lipoma feels hard.

2. Neurolipoma: Painful Jipoma, because of presence of nerve elements.

3. Naevolipoma: Lipoma is usually relatively avascular but this variety is vascular.

Complications

1. Liposarcoma-The current view is that lipomas are benign and do not turn into malignancy. However, a few retroperitoneal lipomas and lipoma in the thigh can tum into liposarcoma after many years of growth. Malignancy should be suspected when:

• The swelling grows rapidly.

• It becomes painful due to infiltration of nerves.

• The swelling becomes vascular and red coloured with di lated veins over the surface.

• Surface is warm due to increased vascularity.

• Skin fungation or fixation occurs later.

• Mobility gets restricted because of infiltration into deeper planes such as muscle.

2. Calcification

3. Myxomatous degeneration: Occurs only in retroperitoneal lipoma.

4. Intussusception

5. Saponification

SOME 'RARE' FACTS IN LIPOMA

• It is rare in children

• Rarely gives rise to transillumination (if size is big)

• Rarely gets infected (because it is relatively avascular)

• Diffuse variety is rare

• Neurolipomas are rare

• Rarely they turn into malignancy

 

 

 

 

TREATMENT AT DR. SOHAN LAL CLINIC

The integrated POLYCLINIC facility offers patients to select their treatment either from the Department of Homeopathy or from the Department of Medicine.

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