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Massive Localized Lymphedema: A Soft Tissue Process that May Present to Dermatologists

Wang, Nadia S MD; Walters, Ruth F MD; Warren, Simon J MBBS

The American Journal of Dermatopathology: June 2010 - Volume 32 - Issue 4 - p 380-383
doi: 10.1097/DAD.0b013e3181bede0a
Extraordinary Case Report

Massive localized lymphedema (MLL) is a clinically and histologically distinct entity seen in morbidly obese patients. We describe two obese patients with MLL in the lower abdomen and suprapubic area. Biopsies showed characteristic histologic features of an expanded dermis with lymphangiectases, fibrotic septae and focal fat necrosis. One patient had long-standing hypothyroidism, an association previously reported. This disease is frequently complicated by recurrent cellulitis and may be amenable to surgery. Patients with MLL may present to dermatologists, and this disease has characteristic histopathologic findings that may mimic liposarcoma to the unaware dermatopathologist.

From the *Section of Dermatopathology, Department of Dermatology, New York University School of Medicine, New York, NY; and †Department of Pathology, Indiana University, Indianapolis, IN.

Funding sources: None.

Reprints: Nadia S. Wang, MD, Section of Dermatopathology, New York University School of Medicine, 530 First Avenue, Suite 7J, New York, NY 10016 (e-mail:

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