Lymph nodes - not lymphoma
Inclusions, pigment, ectopic cells or tissue
Adipose tissue metaplasia



Senior Author: Abdelsalam Sharabi, M.D.
Jayalakshmi Balakrishna, M.D.

Topic Completed: 1 January 2014

Revised: 1 February 2019, last major update January 2014

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Adipose tissue metaplasia



Jayalakshmi Balakrishna, M.D.
Page views in 2018: 5,015
Page views in 2019 to date: 2,020
Cite this page: Balakrishna J. Adipose tissue metaplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodesadiposetissuemetaplasia.html. Accessed June 18th, 2019.
Definition / general
  • Pathological enlargement of lymph nodes caused by abnormal accumulation of fat, due to mature, benign adipocytes within lymph node capsules
Terminology
  • Lipo-lymph nodes
  • Lipoplastic lymphadenopathy
Epidemiology
  • Very common
Sites
  • Most commonly involved sites are external iliac and obturator groups
Pathophysiology
  • Accumulation of abnormal quantities of fat within lymph nodes in excess of normal aging changes
  • Benign process with good prognosis
  • Can cause mass effect depending on size
  • May mimic lymphoma or other neoplasms
Etiology
  • Unknown; postulated causes include exaggeration of normal fat deposition with aging, previous abdominal inflammatory disease, obesity
Clinical features
  • Enlarged lymph nodes; may lead to formation of large masses up to 10 cm
Diagnosis
  • Lymph node biopsy
Radiology description
  • Progressive enlargement and increased fatty infiltration
  • CAT scan and lymphangiography findings can be misleading towards neoplastic process
Case reports
Treatment
  • Excision of involved lymph node in symptomatic cases serves both diagnostic and therapeutic purposes
Clinical images

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Progressively enlarging lymph node

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Largest intra-abdominal adenopathy

Gross description
  • Enlarged lymph node with soft greasy yellow areas within capsule, or entirely replaced by similar cut surfaces
Gross images

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Lymph node replaced by adipose tissue

Microscopic (histologic) description
  • Benign mature adipocytes populate nodes whose capsules are thinly attenuated with fine vascular trabeculae dividing fat deposits
Microscopic (histologic) images

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Lipomatosis



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Benign fibroadipose tissue

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Lymphoid tissue closely admixed with adipocytes

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Lymph node with adipocytes within capsule

Differential diagnosis
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