JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
RADIOLOGY CASE OF THE MONTH
Multiple Symmetric Lipomatosis: Madelung’s Disease
Matthew Brunner, MD; Enrique Palacios, MD, FACR Harold R. Neitzschman, MD, FACR; Jeremy Nguyen, MD
A 56 year old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulderswere noted. The patient’s historywas significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary hypertension and alcoholic cardiomyopathy. He had multi-decade history of heavy alcohol abuse, but quit drinking two years previously.
FIGURE: CT examination post-contrast. (A and B) Axial sections of the upper and lower neck respectively revealed symmetrical non-encapsulated fat deposits with significant compromise of the airways (airway tube in-place). (C) Coronal section of the neck revealed symmetrical non-encapsulated lipomatosis in the posterior cervical spaces (tracheotomy tube in-place).
What is your diagnosis? Elucidation is on page 61.
60 J La State Med Soc VOL 169 MARCH/APRIL 2017
Made with FlippingBook Digital Publishing Software