A 45-year old man presented with 3-year history of a painless soft and slow growing swelling of the neck, upper trunk, upper back and shoulders. The patient had a history ofheavy alcohol consumpution and was a non-smoker. Laboratory blood analysis showed minor elevations in aspaate aminotransfe! rase (71U per liver), alanine amino-transferase (49 U per liter), and total cholesterol . Triglycerides were elevated at 1,020 mg per deciliter (11.52 mmol per liter). Magnetic resonance imgaing revealed diffuse, non-encapsulated fatty deposits in the mediastinum and in the subcutaneous and deeper fascial compaments of the neck, upper trunk and back. The probable diagnosis of the patient is -
Madelung's disease is characterized by massive deposits of fatty tumors (lipoma) located symmetrically around the neck, and on the shoulders, upper arms and upper trunk. These abnormal fat deposits may grow rapidly over the course of months or more slowly over a period of years Ref Davidson 23rd edition pg 739
Tuberculosis
Rheumatoid almtis
Madelung's disease
Hodgkin's lymphoma
Miscellaneous