obsolete lipogranuloma

Obsolete Lipogranuloma

Lipogranuloma, also known as paraffinoma or oil granuloma, is a type of granulomatous foreign body reaction that results from the interstitial application of oily substances. This condition was previously referred to as an obsolete lipogranuloma.

Characteristics

• A granulomatous foreign body reaction
• Results from the interstitial application of oily substances
• Can be caused by injection of paraffin, wax, silicone, or oil into the skin or subcutaneous tissue

Causes and Associations

• Injection of illicit foreign materials for penile augmentation can lead to sclerosing lipogranuloma of the penis
• Penile lipogranuloma is usually due to hypodermic injection of substances such as paraffin, silicone, oil, or wax into the penis for penile enlargement or sexual gratification

References

[1] May 15, 2014 — Paraffinoma is a granulomatous foreign body reaction that results from the interstitial application of oily substances. (Search result 1) [2] by CI Lym · 2015 · Cited by 12 — Oleoma is a non-allergic, foreign body type granulomatous reaction. It appears as response to oily exogenous substances injected to the dermis or subcutis ... (Search result 3)

Diagnostic Tests for Obsolete Lipogranuloma

Obtaining an accurate diagnosis for lipogranuloma, particularly the obsolete type, is crucial for effective treatment and management. The following diagnostic tests can be employed to confirm or rule out this condition:

• Imaging Studies: Imaging studies are extremely valuable in the diagnosis of FMAR (Foreign Material Associated Reaction) and its complications [4]. A chest x-ray may show the presence of pleuritis, pneumonitis, and/or mediastinal widening.
• Biopsy: A biopsy is a crucial diagnostic tool for lipogranuloma. It involves taking a sample of tissue from the affected area and examining it under a microscope. The biopsy can help confirm the diagnosis and rule out other conditions [13].
• Histological Examination: Histological examination of the biopsy sample can provide detailed information about the presence of foreign body histiocytes, lipid vacuoles, and sclerotic stroma, which are characteristic features of lipogranuloma [11].
• Cytological Examination: Cytological examination of the biopsy sample can also be performed to rule out other conditions such as lymphoma or metastatic cancer [15].

Other Diagnostic Procedures

In addition to these diagnostic tests, other procedures may be employed to aid in diagnosis. These include:

• Pelvic Computed Tomography (CT): Pelvic CT scans may be used to evaluate the extent of disease and rule out complications such as lymphadenopathy or constitutional symptoms [7].
• Diagnostic Lymphangiogram: Although no longer a standard test, diagnostic lymphangiograms can be performed in some cases to aid in diagnosis. However, this procedure is not commonly used due to its invasive nature.

Important Considerations

It's essential to note that lipogranuloma can mimic other conditions such as lymphoma or metastatic cancer, making differential diagnosis crucial [15]. A thorough evaluation of the patient's medical history, physical examination, and laboratory results is necessary to arrive at an accurate diagnosis.

Based on the provided context, it appears that there are various treatment options for lipogranuloma, but the effectiveness and appropriateness of these treatments may vary depending on the specific case.

• Surgery: According to search result [11], radical excision of all lesions followed by skin grafting is considered the treatment of choice. However, it's essential to note that surgery should be reserved for recurrent or refractory cases when steroids have failed as first-line treatment (search result [1]).
• Steroids: Intra-lesional or systemic steroids have been used in primary sclerosing lipogranuloma, resulting in the disappearance of the granuloma (search results [14] and [2]). However, their effectiveness may vary depending on the individual case.
• Colchicine: A conservative treatment with colchicine was attempted in one case (search result [13]), but it's unclear whether this treatment was effective or not.
• Other treatments: There is limited information available on other potential treatments for lipogranuloma, such as antibiotic or corticosteroid treatment (search result [6]).

It's essential to consult with a medical professional to determine the most appropriate course of treatment for an individual case of lipogranuloma. They can assess the specific situation and provide guidance on the best treatment options available.

References: [1] Context search result 1 [2] Context search result 2 [6] Context search result 6 [11] Context search result 11 [13] Context search result 13 [14] Context search result 14

The differential diagnosis for obsolete lipogranuloma, as mentioned in search result [6], includes various conditions that can mimic the clinical and radiologic features of this condition.

• Lipoid pneumonia: This condition can present with similar clinical and radiologic features to lipogranuloma, making it a challenging differential diagnosis (search result [9]).
• Primary lung carcinoma: Lipoid pneumonia can also be mistaken for primary lung carcinoma due to its similar presentation (search result [9]).
• Signet ring cell carcinoma: This type of cancer can present with similar histopathological features to lipogranuloma, making it an important differential diagnosis (search results [10] and [11]).
• Malakoplakia: This rare condition can also be considered in the differential diagnosis for lipogranuloma due to its similar presentation (search result [12]).

It's worth noting that the diagnosis of lipogranuloma may be confirmed by histochemical stains for lipid, but light microscopy is usually sufficient (search result [14]).