Case for diagnosis
Mobile Nodules on the Legs
Nódulos desplazables en las piernas
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On both lower limbs she presented painless, movable nodules along the length of the limb that had been present for 2 months. She described the nodules as “moving lentils”. There was no history of trauma, but the patient associated the condition with the use of strong compression stockings.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination, 8 to 10 subcutaneous nodules of 0.5<span class="elsevierStyleHsp" style=""></span>cm in diameter were palpable on each leg. The nodules were hard, well-defined, and could be rolled between the fingers; they could be easily moved between the skin and deeper planes and their movement was not limited to the trajectory of blood vessels (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Macroscopic examination revealed a solid, hard, yellowish spherical nodule of 0.4<span class="elsevierStyleHsp" style=""></span>cm in diameter, with a pearly appearance. Histologic examination showed fat lobules composed of necrotic adipocytes lacking nuclei and surrounded by a fibrous capsule (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">Blood analysis revealed hyperlipidemia, elevated creatinine levels, and mild leukocytosis, with no other abnormalities. Soft tissue ultrasound revealed small areas of edema in the subcutaneous cellular tissue, with no other relevant findings.</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis?</span></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Diagnosis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Encapsulated fat necrosis.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Clinical Course and Treatment</span><p id="par0035" class="elsevierStylePara elsevierViewall">It was decided to maintain the patient under observation and, after 1 year of follow-up, the condition remained stable, with no new lesions detected.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Comment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Encapsulated fat necrosis was first described in 1977 by Przyjemski and Schuster,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and since then about 53 cases have been reported in the literature.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This condition is known by many different names, including mobile encapsulated lipoma, nodular-cystic fat necrosis, and encapsulated fat necrosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">This dermatosis has been described in middle-aged women and in young men, particularly in athletes (skiers, etc), and predominantly affects the lower limbs.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In some cases it has been detected on the upper limbs and hips. The condition usually presents as solitary or multiple subcutaneous nodules, ranging in size from 2 to 35<span class="elsevierStyleHsp" style=""></span>mm. Cases associated with Ehlers-Danlos syndrome<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and erythema nodosum,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> among other conditions, have been described.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Histopathologically, the nodules consist of degenerated or necrotic adipose tissue surrounded by a fibrous capsule composed of several layers of connective tissue. In some cases there may be foci of calcification, fibrous septa within the lesion, and lipomembranous changes.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The most widely accepted hypothesis is that this condition is caused by trauma that decreases blood supply to a fat lobule, resulting in ischemic infarction and subsequent ischemic necrosis of the tissue. A fibrous capsule then forms around the necrotic tissue, creating a cleavage plane that separates it from the surrounding tissue and allows it to move freely throughout the subcutaneous cellular tissue. Because these lesions lack blood supply, they cannot be reabsorbed and persist as encapsulated remnants of necrotic adipose tissue.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The clinical differential diagnosis mainly includes soft tissue tumors, phleboliths, rheumatoid nodules, gout, calcinosis cutis, amyloidoma, and foreign body reaction. The histopathological differential diagnosis primarily includes traumatic panniculitis, lipomas and angiolipomas, pancreatic fat necrosis, and panniculitis due to α<span class="elsevierStyleInf">1</span>-antitrypsin deficiency.</p><p id="par0065" class="elsevierStylePara elsevierViewall">This condition is probably more common than reported. Similar lesions have been described as errant bodies in a submuscular plane, in the pericardium, and in the abdominal cavity.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In conclusion, we present a striking case of multiple lesions of encapsulated fat necrosis, primarily characterized by their mobility.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Additional Tests" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Diagnosis" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Clinical Course and Treatment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Comment" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Burgués M, et al. Nódulos desplazables en las piernas. Actas Dermosifiliogr. 2012;103:923–4.</p>" ] ] "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1250 "Ancho" => 1267 "Tamanyo" => 162841 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1042 "Ancho" => 1087 "Tamanyo" => 171608 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification ×25.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 600 "Ancho" => 1000 "Tamanyo" => 76890 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification ×100.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nodular-cystic fat necrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.J. Przyjemski" 1 => "S.R. Schuster" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "1977" "volumen" => "91" "paginaInicial" => "605" "paginaFinal" => "607" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/908980" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Encapsulated fat necrosis - a clinicopathological study of 8 cases and a literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Kiryu" 1 => "W. Rikihisa" 2 => "M. Furue" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2000" "volumen" => "27" "paginaInicial" => "19" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10660127" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nodular-cystic fat necrosis. A reevaluation of the so-called mobile encapsulated lipoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.A. Hurt" 1 => "D.J. Santa Cruz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1989" "volumen" => "21" "paginaInicial" => "493" "paginaFinal" => "498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2674212" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Encapsulated fat necrosis in a patient with Ehlers-Danlos syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Ohtake" 1 => "A. Gushi" 2 => "S. Matsushita" 3 => "T. Kanzaki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "1997" "volumen" => "24" "paginaInicial" => "189" "paginaFinal" => "192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9085156" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nodular cystic fat necrosis in a patient with erythema nodosum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.K. Ahn" 1 => "B.J. Lee" 2 => "S.H. Lee" 3 => "W.S. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "263" "paginaFinal" => "265" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7671430" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Encapsulated pericardial fat necrosis treated by video-assisted thoracic surgery: report of a case" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Inoue" 1 => "S. Fujino" 2 => "N. Tezuka" 3 => "S. Sawai" 4 => "K. Kontani" 5 => "J. Hanaoka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s005950070088" "Revista" => array:6 [ "tituloSerie" => "Surg Today" "fecha" => "2000" "volumen" => "30" "paginaInicial" => "739" "paginaFinal" => "743" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10955740" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000010/v1_201304241352/S1578219012003125/v1_201304241352/en/main.assets" "Apartado" => array:4 [ "identificador" => "6154" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000010/v1_201304241352/S1578219012003125/v1_201304241352/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012003125?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 25 | 17 | 42 |
| 2024 Octubre | 218 | 57 | 275 |
| 2024 Septiembre | 196 | 45 | 241 |
| 2024 Agosto | 263 | 92 | 355 |
| 2024 Julio | 237 | 51 | 288 |
| 2024 Junio | 200 | 46 | 246 |
| 2024 Mayo | 191 | 42 | 233 |
| 2024 Abril | 149 | 31 | 180 |
| 2024 Marzo | 187 | 33 | 220 |
| 2024 Febrero | 197 | 38 | 235 |
| 2024 Enero | 206 | 44 | 250 |
| 2023 Diciembre | 203 | 34 | 237 |
| 2023 Noviembre | 202 | 40 | 242 |
| 2023 Octubre | 191 | 23 | 214 |
| 2023 Septiembre | 207 | 34 | 241 |
| 2023 Agosto | 166 | 33 | 199 |
| 2023 Julio | 153 | 44 | 197 |
| 2023 Junio | 157 | 45 | 202 |
| 2023 Mayo | 171 | 37 | 208 |
| 2023 Abril | 131 | 38 | 169 |
| 2023 Marzo | 109 | 36 | 145 |
| 2023 Febrero | 114 | 36 | 150 |
| 2023 Enero | 111 | 54 | 165 |
| 2022 Diciembre | 66 | 54 | 120 |
| 2022 Noviembre | 44 | 27 | 71 |
| 2022 Octubre | 35 | 37 | 72 |
| 2022 Septiembre | 34 | 56 | 90 |
| 2022 Agosto | 33 | 33 | 66 |
| 2022 Julio | 44 | 44 | 88 |
| 2022 Junio | 52 | 38 | 90 |
| 2022 Mayo | 166 | 47 | 213 |
| 2022 Abril | 130 | 48 | 178 |
| 2022 Marzo | 120 | 57 | 177 |
| 2022 Febrero | 126 | 45 | 171 |
| 2022 Enero | 188 | 58 | 246 |
| 2021 Diciembre | 124 | 51 | 175 |
| 2021 Noviembre | 105 | 68 | 173 |
| 2021 Octubre | 90 | 45 | 135 |
| 2021 Septiembre | 115 | 48 | 163 |
| 2021 Agosto | 98 | 49 | 147 |
| 2021 Julio | 95 | 37 | 132 |
| 2021 Junio | 108 | 36 | 144 |
| 2021 Mayo | 80 | 47 | 127 |
| 2021 Abril | 229 | 70 | 299 |
| 2021 Marzo | 95 | 26 | 121 |
| 2021 Febrero | 80 | 26 | 106 |
| 2021 Enero | 43 | 23 | 66 |
| 2020 Diciembre | 40 | 24 | 64 |
| 2020 Noviembre | 23 | 20 | 43 |
| 2020 Octubre | 17 | 8 | 25 |
| 2020 Septiembre | 35 | 8 | 43 |
| 2020 Agosto | 21 | 25 | 46 |
| 2020 Julio | 20 | 18 | 38 |
| 2020 Junio | 34 | 27 | 61 |
| 2020 Mayo | 21 | 19 | 40 |
| 2020 Abril | 30 | 22 | 52 |
| 2020 Marzo | 22 | 19 | 41 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 4 | 4 | 8 |
| 2019 Diciembre | 8 | 8 | 16 |
| 2019 Noviembre | 4 | 1 | 5 |
| 2019 Octubre | 0 | 4 | 4 |
| 2019 Septiembre | 8 | 2 | 10 |
| 2019 Agosto | 2 | 0 | 2 |
| 2019 Julio | 6 | 7 | 13 |
| 2019 Junio | 6 | 39 | 45 |
| 2019 Mayo | 4 | 42 | 46 |
| 2019 Abril | 2 | 6 | 8 |
| 2019 Marzo | 2 | 8 | 10 |
| 2019 Febrero | 2 | 5 | 7 |
| 2019 Enero | 2 | 0 | 2 |
| 2018 Diciembre | 5 | 4 | 9 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 3 | 7 | 10 |
| 2018 Agosto | 0 | 20 | 20 |
| 2018 Julio | 0 | 4 | 4 |
| 2018 Junio | 0 | 6 | 6 |
| 2018 Mayo | 0 | 10 | 10 |
| 2018 Abril | 0 | 6 | 6 |
| 2018 Marzo | 0 | 8 | 8 |
| 2018 Febrero | 54 | 12 | 66 |
| 2018 Enero | 54 | 9 | 63 |
| 2017 Diciembre | 55 | 10 | 65 |
| 2017 Noviembre | 33 | 10 | 43 |
| 2017 Octubre | 40 | 10 | 50 |
| 2017 Septiembre | 40 | 14 | 54 |
| 2017 Agosto | 38 | 19 | 57 |
| 2017 Julio | 30 | 15 | 45 |
| 2017 Junio | 54 | 32 | 86 |
| 2017 Mayo | 31 | 18 | 49 |
| 2017 Abril | 36 | 11 | 47 |
| 2017 Marzo | 32 | 19 | 51 |
| 2017 Febrero | 72 | 21 | 93 |
| 2017 Enero | 40 | 12 | 52 |
| 2016 Diciembre | 52 | 11 | 63 |
| 2016 Noviembre | 59 | 13 | 72 |
| 2016 Octubre | 86 | 11 | 97 |
| 2016 Septiembre | 157 | 16 | 173 |
| 2016 Agosto | 76 | 18 | 94 |
| 2016 Julio | 53 | 7 | 60 |
| 2016 Junio | 10 | 15 | 25 |
| 2016 Mayo | 6 | 12 | 18 |
| 2016 Abril | 6 | 20 | 26 |
| 2016 Marzo | 8 | 0 | 8 |
| 2016 Febrero | 7 | 5 | 12 |
| 2016 Enero | 8 | 0 | 8 |
| 2015 Diciembre | 13 | 2 | 15 |
| 2015 Noviembre | 17 | 1 | 18 |
| 2015 Octubre | 15 | 3 | 18 |
| 2015 Septiembre | 16 | 3 | 19 |
| 2015 Agosto | 18 | 4 | 22 |
| 2015 Julio | 64 | 16 | 80 |
| 2015 Junio | 46 | 7 | 53 |
| 2015 Mayo | 90 | 14 | 104 |
| 2015 Abril | 77 | 13 | 90 |
| 2015 Marzo | 64 | 9 | 73 |
| 2015 Febrero | 53 | 12 | 65 |
| 2015 Enero | 50 | 9 | 59 |
| 2014 Diciembre | 52 | 12 | 64 |
| 2014 Noviembre | 23 | 2 | 25 |
| 2014 Octubre | 26 | 2 | 28 |
| 2014 Septiembre | 19 | 3 | 22 |
| 2014 Agosto | 20 | 4 | 24 |
| 2014 Julio | 20 | 6 | 26 |
| 2014 Junio | 30 | 3 | 33 |
| 2014 Mayo | 38 | 7 | 45 |
| 2014 Abril | 24 | 8 | 32 |
| 2014 Marzo | 24 | 6 | 30 |
| 2014 Febrero | 15 | 4 | 19 |
| 2014 Enero | 14 | 2 | 16 |
| 2013 Diciembre | 22 | 2 | 24 |
| 2013 Noviembre | 12 | 5 | 17 |
| 2013 Octubre | 9 | 1 | 10 |
| 2013 Septiembre | 7 | 6 | 13 |
| 2013 Agosto | 9 | 8 | 17 |
| 2013 Julio | 9 | 10 | 19 |
| 2013 Junio | 6 | 10 | 16 |
| 2013 Mayo | 13 | 2 | 15 |
| 2013 Abril | 19 | 8 | 27 |
| 2013 Marzo | 18 | 11 | 29 |
| 2013 Febrero | 45 | 3 | 48 |
| 2013 Enero | 41 | 5 | 46 |
| 2012 Diciembre | 23 | 4 | 27 |
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