Superficial soft-tissue masses: analysis, diagnosis, and differential considerations.

A wide variety of superficial soft-tissue masses may be seen in clinical practice, but a systematic approach can help achieve a definitive diagnosis or limit a differential diagnosis. Superficial soft-tissue masses can generally be categorized as mesenchymal tumors, skin appendage lesions, metastatic tumors, other tumors and tumorlike lesions, or inflammatory lesions. With regard to their imaging features, these masses may be further divided into lesions that arise in association with the epidermis or dermis (cutaneous lesions), lesions that arise within the substance of the subcutaneous adipose tissue, or lesions that arise in intimate association with the fascia overlying the muscle. The differential diagnosis may be limited further by considering the age of the patient, anatomic location of the lesion, salient imaging features, and clinical manifestations.

Utility of subcutaneous fat aspiration for diagnosing amyloidosis in patients with isolated peripheral neuropathy.

OBJECTIVE: To determine the value of subcutaneous fat aspiration in patients with sensorimotor peripheral neuropathy. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all patients undergoing subcutaneous fat aspiration for suspected amyloidosis from January 1, 1994, through December 31,1999. We classified patients undergoing subcutaneous fat aspiration due to peripheral neuropathy into 2 groups: (A) those with isolated peripheral neuropathy and (B) those with any family history and laboratory or clinical findings typically associated with systemic amyloidosis. RESULTS: The study population consisted of 450 patients with peripheral neuropathy in whom fat aspiration was performed for suspected amyloidosis. This constituted 56% of all fat aspirations performed during the study period. Group A had 143 patients, and group B had 307 patients. None of the patients in group A had a positive subcutaneous fat aspirate, whereas 17 patients (6%) in group B had a positive subcutaneous fat aspirate (P=.002, Fisher exact test). The subcutaneous fat aspirate was most commonly positive in patients with a monoclonal protein or other clinical findings associated with amyloidosis. CONCLUSIONS: The yield of a subcutaneous fat aspirate in patients with isolated peripheral neuropathy and no other associated family history, signs, or symptoms of amyloidosis is low. Subcutaneous fat aspiration should be reserved for evaluating patients with peripheral neuropathy who also have findings associated with systemic amyloidosis.

Herpes zoster as a rare complication of liposuction.

Liposuction typically has a low incidence of complications and is associated with significant cosmetic benefit. In this case, the patient developed a dermatomal rash with vesicles on an erythematous base consistent with herpes zoster 8 days after liposuction to the back and flanks. To the authors' knowledge, herpes zoster has not been previously reported as a complication of liposuction. Although the precise relationship of herpes zoster infection to the liposuction procedure is difficult to determine, mechanical irritation most likely reactivated the varicella zoster virus in the involved dermatomal distribution. The patient was treated with antiviral and analgesic medications and healed without any further complications.