Massive localized lymphedema is a localized lymphedema seen in obese adults.


Sites affected include:

(1) thigh

(2) pubic region


Clinical features:

(1) localized swelling in an obese adult

(2) thickened skin with peau d'orange change


Pathologic features:

(1) edematous dermis and subcutaneous tissue with or without hyalinization

(2) numerous distended small and medium sized lymphatic channels

(3) small blood vessels with thickened walls

(4) lymphocytic infiltrate with lymphoid follicles, with increased CD4+ T cells

(5) absence of necrosis or hemorrhage

(6) absence of atypical mitotic figures, nuclear atypia and lipoblasts


Differential diagnosis:

(1) panniculitis

(2) well-differentiated liposarcoma


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