Lipomatosis is the accumulation of fat cells in a certain area of the body. Lipomatous foci are single or multiple, but they are always a localized formation, with or without a capsule. Pathology can be formed both in the subcutaneous tissue and in the internal organs (for example, the kidneys, heart, pancreas are damaged). Lipomatosis - what is it and what are its manifestations - is described in detail in this article.
Causes of illness
The etiology of the disease, unfortunately, is not known, however, there is data indicating the relationship of changes in the type of lipomatosis with a disorder of carbohydrate and lipid metabolism, stress, hereditary (genetic) burden and external adverse factors.
It has been proven that the basis of Derkum's disease is polyglandular endocrinopathy, which is obesity, the genesis of which is not known. Lipomatosis of the interatrial septum in 80% of cases develops against the background of general obesity, and in 20% - against the background of type 2 diabetes. Moreover, almost all patients with lipomatosis are patients with a cardiological profile, that is, they suffer from variouspathologies of the heart (aneurysms, coronary artery disease, and so on).
Congenital lipomatosis, Madelung syndrome, Lery-Roche disease and the plasma form of the disease are hereditary diseases in which there is a congenital lipid metabolism disorder.
Forms of lipomatosis
There are several varieties of the disease:
diffuse option;
- knotty shape - characterized by the formation of dense, well-defined, painful fatty nodes;
- mixed form (diffuse-nodular).
In addition, the disease is classified according to the localization of the process: lipomatosis of the pancreas and thyroid glands, liver, skin, lymph nodes, and so on.
There are also special forms of the disease that have a characteristic localization of formations:
- Derkum syndrome. It is accompanied by the appearance of multiple painful (or cutting-itching) lipomas, growing in the lumbar region and limbs, depression and impotence. Pathology is hereditary.
- Epidural lipomatosis. Accompanied by the accumulation of fat cells between the vertebral periosteum and the dura mater. The cause of the process is often taking corticosteroid drugs or general obesity. This form of lipomatosis often develops along with pituitary tumors (prolactinoma) and Cushing's syndrome.
- Gram syndrome. It is considered a variant of Derkum's syndrome and is the formation of multiple lipomas in women 45-70 years of age who are obese and have a burdenedheredity. In this case, the formations are located on the knee joints and lower back.
- Renal sinus lipomatosis. This form is accompanied by a pathological growth of adipose tissue in the kidneys (their sinuses and peripheral parts), leading to atrophy of the renal parenchyma and fibrosis of the tissues of the organ. Most often, such lipomatosis is combined with urolithiasis and is manifested by prolonged hyperthermia (up to 37-38 degrees) and back pain.
- Roche-Lerry syndrome. Such lipomatosis is the lot of patients 40-60 years old. It rarely occurs in children. Characteristic of this form is the formation of neoplasms on the buttocks and arms. In some cases, lipomas can also occur on the internal (mainly digestive) organs. The disease develops due to trophic changes or in the presence of a genetic predisposition.
Hypertensive subcutaneous lipogranulomatosis. This form is very rare, and therefore little studied. Obese women with GB suffer from this disease. The disease manifests itself by the formation of rapidly growing dense knots on the thighs and legs, often undergoing central decay with preliminary softening
Other types of disease
- Children's diffuse lipomatosis - this disease affects exclusively children. At the same time, pathological formations are found on the forearms and thighs and are often accompanied by a pathological increase in muscle volume, in addition, lipomas are localized in the connective tissue, parenchyma of organs and do not have clear boundaries, the courseswift. In most cases, the pathology is hereditary.
- Hypertrophic form. It is a symmetrical generalized accumulation of adipose tissue between atrophied muscle fibers, resulting in the patient looking like Hercules.
- Poten-Verneuil lipomatosis. Manifested by the formation of nodular lipomas in the supraclavicular fossae.
- Symmetrical limited shape. Accompanied by the appearance of fat nodes up to 4 cm on the arms, abdomen, hips, lower back. As a rule, it develops in patients 35-40 years of age and extremely rarely in children.
- Pasteur's lipomatosis and palmar form.
- Segmental form.
Pancreatic lesion
Gland lipomatosis (whether pancreatic or thyroid) is an irreversible, slowly progressing benign process in which normal organ cells are replaced by fat cells, as a result of which its function is impaired.
Among the factors leading to the formation of this disease, we can distinguish: diabetes mellitus, various injuries and inflammatory processes, organ damage by toxins (alcohol and others). An important factor is the burdened heredity.
Process steps
For an easier formulation of the diagnosis and the appointment of adequate treatment, doctors use the division of the process in the pancreas according to the type of lipomatosis into degrees:
- 1 degree. The course is asymptomatic, the process is compensated, damage affects only 30% of the organ.
- 2 degree. Fat cells replace up to 60%glandular tissue. There are non-specific symptoms of indigestion.
- 3 degree. Adipose tissue occupies more than 60% of the tissues of the organ, significantly impairing its work. That is, the glandular cells do not produce enough hormones and enzymes, as a result of which insulin ceases to be synthesized and, as a result, the amount of glucose increases significantly and complications develop.
There is another division of lipomatosis, according to which the following forms are distinguished:
- small focal (diffuse);
- island.
Diagnosis
Diagnosis of this disease of the pancreas is reduced to ultrasound and CT. At the same time, a gland of normal size is found, but its structure has an increased echogenicity.
The most reliable research method is a biopsy, during which fat cells are found instead of normal tissue.
Condition Therapy
Patients are often interested in the question of how to treat pancreatic lipomatosis.
Most often, conservative methods are prescribed for the treatment of this disease. In this case, the patient is invited to lose weight, adjust the diet and get rid of bad habits. Of the medications, enzymatic and hormonal drugs are prescribed to eliminate the "malfunctions" of digestion and hormone deficiency.
In addition, the treatment of concomitantailments (DM, hepatitis, thyroid disease), if any.
In cases where conservative therapy does not have the desired effect, lipomatous areas will be removed promptly.
Injury to other organs
Lipomas can form anywhere in the body from the mediastinum to the kidneys.
The formation of lipomas in the mammary glands is quite rare. The cause of the pathological process in this case may be weight loss or weight gain, an increase in the size of the glands during pregnancy or lactation. The diameter of the wen can be up to 10 cm, if the knot is large - chest deformity is possible. The process is long, slowly progressive and asymptomatic (the only exception is the involvement of the nerves in the process or their compression by the lipoma, which leads to pain). It should be noted that lipomatosis rarely occurs directly in the mammary gland, more often this process is observed in the breast subcutaneous tissue.
It is possible that an ailment may also occur in the liver tissue. In this case, the process occurs as a result of metabolic disorders in the tissues of organs, for example, due to excessive alcohol consumption. Fatty acids are intensively supplied from the surrounding fatty tissue, and then the fat cells begin to be produced by the liver itself. Patients complain of weakness, soreness of a blunt nature in the side on the right, and loss of appetite. Pathology is diagnosed by CT or ultrasound. There are small- and large-drop varieties of the disease.
Cardiac lipomatosis is most often found in the atrial septum and is characterized by accumulationfat in myocardiocytes. As a result, the myocardium does not carry out full contractions, arrhythmias and blockades may occur, the chambers are stretched, the heart increases in size and heart failure develops.
Kidney lipomatosis occurs as a result of diabetes mellitus, amyloidosis, glomerulonephritis. It is accompanied by an increase in the organ, swelling of the cortical layer and accumulation of fat in the tubules and ultimately leads to the death of nephrocytes. The functions of the organ are disrupted up to the development of renal failure and the complete cessation of the work of the damaged kidney.
General principles of treatment
Often patients are interested in the question of how to treat lipomatosis.
It is worth noting that the choice of therapy depends on the form of the disease, its localization and severity.
Treatment of lipomatosis is often surgical, but after that the disease can recur. In the case of diffuse nodular forms, the operation may be complicated by bleeding due to damage to the developed vascular network in the formation.
Derkum Syndrome involves symptomatic treatment. So, in the presence of hypofunction of the glands, hormonal therapy is prescribed, with an increase in body weight - a diet, and in case of mental disorders - specific drugs that affect the mental state of the patient. Operations in this case are ineffective due to frequent recurrence, however, surgical treatment is still carried out with severe pain or if the knots interfere with movement or wearing clothes.
Lipomasmammary glands are observed, removed surgically or without intervention (introduction of diprospan, laser, and so on).
Risk groups
The risk groups for lipomatosis include persons who have close relatives (parents) suffering from this disease; patients with diabetes mellitus, overweight, hypertension, endocrine pathologies.
Preventive measures
There is no specific prevention of the disease. However, to some extent, lipomatosis can be prevented by maintaining a normal weight, eradicating bad habits and timely treatment of diseases.
