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Date of last update: 10/19/2017.

Forum Name: Miscellaneous Chest Diseases

Question: Is it possible that a lung granuloma could be a lipoma?

 daddysnurse - Sun Aug 01, 2010 11:40 pm

I had a chest CT done about 2 months ago as a result of an auto accident. I did not have any fractures, but was told I had a granuloma in one of my lungs that would need to be followed up on.
Because I've had numerous lipomas removed from my body (over 200) I am curious to know if there is a reason for follow-up as soon as the 3 months it was recommended and whether or not it is possible that this could actually be a lipoma? I know that if it were a lipoma, it would not need to be removed or followed up on unless other symptoms were present.
 Dr.M.Aroon kamath - Thu Aug 05, 2010 5:23 am

User avatar Hi,
Multiple subcuteneous lipomas are only extremely rarely described in association with lipomas within the body cavities.
In one case report, a corpus callosal-choroid plexus lipoma was associated with a subcutaneous lipoma and one other case report a laryngeal lipoma was found associated with diffuse systemic lipomatosis.

Lipomas are one of the most frequently encountered benign neoplasms, but intrathoracic lipomas are very rare. Intrathoracic lipomas may occur in the following sites.
- medistinal and
- intra pulmonary.

A majority of the intra pulmonary lipomas are centrally placed within the lung, arising mostly from proximal lobar or segmental bronchi(mostly seen in endobronchial localization).

The first case of peripheral intrapulmonary lipoma was reported way back in 1911. Only a handful of cases (perhaps < 10) have been reported since then. These tumors are presumed to originate from fatty tissue in the wall of peripheral, subsegmental bronchi. Almost all occurrences were in adult males(age range 44–71 years).

Treatment for endobronchial lipoma is usually a bronchoscopic resection.

Centrally located lipomas have been reported very rarely in the trachea as well. These tumors can be difficult to diagnose due to their ability to mimic other obstructive lung diseases, such as COPD and asthma.Treatment is usually endoscopic resection.

Although radiological imaging techniques have high sensitivity detecting solitary pulmonary nodules, their ability to give information about their nature is limited. CT attenuation values of −100 to -110 Hounsfield units, indicates the presence of fat in such tumors.

These tumors are generally unsuitable for bronchoscopic biopsy or resection. So far, almost all the peripherally located intrapulmonary lipomas had been diagnosed following surgery (wedge resection).

Although extremely rare, intrapulmonary lipomas should be considered in the differential diagnosis of solitary pulmonary nodules.

Although you have had mutiple subcuteneous lipomas, to the best of my knowledge, they have not been reported in association with intrapulmonary lipomas. However, the lesion in your lung (as advised by your doctor) needs to be carefully followed up.
Best wishes!

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