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Soft tissue calcifications are a common imaging finding, but in the setting of a cosmetic augmentative injection and hypercalcemia, it may be pathognomonic for lipogranuloma, a delayed granulomatous inflammatory reaction to the injected foreign material. Although diagnosis of lipogranuloma is based on the results of histopathologic examination, the radiologist may play a key role in the clinical evaluation of challenging cases when patients do not report about nonmedical cosmetic procedures. If the treatment of granulomatosis-induced hypercalcemia is not timely, it may result in chronic renal disease and other comorbidities. We report a case of lipogranuloma with extensive subcutaneous calcification and hypercalcemia associated with cosmetic injection.

Intestinal lipogranulomatous lymphangitis (ILL) is a granulomatous inflammation of the lymphatic vessels of the intestinal wall and mesentery characterized by lipogranulomas. The purpose of this retrospective, multi‐center, case series study is to report the ultrasonographic features of canine ILL. Ten dogs with a histologically confirmed ILL undergoing preoperative abdominal ultrasound were retrospectively included. Additional CT was available in two cases. Lesion distribution was focal in eight dogs and multifocal in two. All dogs presented with intestinal wall thickening and two had a concomitant mesenteric mass adjacent to the intestinal lesion. All lesions were in the small intestine. Ultrasonographic features were altered wall layering with predominantly muscular and to a lesser extent submucosal layer thickening. Other findings included hyperechoic nodular tissue within the muscular, serosa/subserosal, and mucosal layers, hyperechoic perilesional mesentery, enlarged submucosal blood/lymphatic vessels, mild peritoneal effusion, intestinal corrugation, and mild lymphadenomegaly. The two intestinal to mesenteric masses presented heterogeneous echostructure, predominantly hyperechoic with multiple hypo/anechoic cavitations filled with mixed fluid and fat attenuation content on CT. Histopathological findings included lymphangiectasia, granulomatous inflammation, and structured lipogranulomas affecting mainly submucosa, muscularis, and serosa. The intestinal to mesenteric cavitary masses revealed severe granulomatous peritonitis with steatonecrosis. In conclusion, ILL should be considered as a differential diagnosis for dogs with this combination of ultrasonographic features. [ABSTRACT FROM AUTHOR]

A case of combined acute and chronic liver injury related to consumption of multi-ingredient nutritional oral supplements containing Aloe Vera gel and vitamin A among other vitamins, minerals and dietary elements such as fish and calamari oil in a 59-year-old female with unexplained hypertransaminasemia is reported. A unique complex liver injury was diagnosed on liver biopsy combining histological features of protracted acute hepatitis, mild manifestation of hypervitaminosis A and lipogranulomatous reaction attributed to Aloe Vera, vitamin A and lipids, respectively. Normalization of liver tests was achieved after discontinuation of all nutritional supplements. Updated Roussel Uclaf Causality Assessment Method (RUCAM) score (+8, probable) further supported herb-induced liver injury. The present case highlights the increasing incidence of complex histological liver injury linked to the constantly growing consumption of multi-ingredient dietary supplements and alternative medications.

Background: The use of vitamin E for Facial rejuvenation is a dangerous practice and is associated with potential local, and sometimes systemic and life‐threatening complications. Clinicians should be aware of complications induced by the injection of illegal products for tissue augmentation. Also, regulatory organizations should monitor illegal beauty centers and enact restrictive laws. Case Presentation: Herein, we report a case of liquid vitamin E injection for cosmetic facial rejuvenation and development of facial persistent erythema and induration, treated with oral prednisolone, azathioprine, and minocycline. Also, we review the reported cases of vitamin E injection for cosmetic facial rejuvenation. Conclusion: Lipogranuloma is one of those complications of vitamin E injection for cosmetic rejuvenation. It mostly represents inflammation, edema, erythema, and tenderness. Since there was no standard treatment for this complication, the management of these patients is challenging. Patients who have undergone cosmetic interventions in illegal institutions are more likely to develop such complications including medical and psychological problems. Clinicians should be aware of these complications for the best diagnosis and treatment. [ABSTRACT FROM AUTHOR]

A 57-year old woman presented with a 6-month history of a left red eye associated with diplopia. Examination was remarkable for 2 mm left-sided axial proptosis and restriction on left upgaze and abduction associated with diplopia. She had no previous history of trauma or surgery to the face. Magnetic resonance imaging revealed an enhancing infiltrative mass in the left intraconal space. Biopsy of the anterior orbital fat revealed extensive lipogranulomatous inflammation with no abnormalities noted on flow cytometry, culture, or special stains. The patient was managed with a tapering course of oral prednisolone and two 40 mg intraorbital triamcinolone injections resulting in complete resolution of her presenting symptoms. This represents a rare case of idiopathic lipogranulomatous orbital inflammation. [ABSTRACT FROM AUTHOR]

The authors present a clinical observation of oleogranuloma of the penis in an adolescent. The analysis of domestic and foreign literature demonstrates the absence of this nosology in adolescence. The relevance of oleogranuloma of the penis and modern tactics of surgical treatment are highlighted.

Penile paraffinoma is a rare condition after penile injection of liquid paraffin or other mineral oils, with well-documented debilitating complications. Nevertheless, such injections are still performed by people of Eastern European and Asian descent for cosmetic penile augmentation. We report a case of penile paraffinoma in an otherwise healthy, 30-year-old male, with obstructive lower urinary tract symptoms (LUTS) as the sole complaint at presentation in the emergency department and a conservative approach. This case report describes an unusual presentation of penile paraffinoma in a young man and aims to raise public and physician awareness regarding disease manifestation to prevent high morbidity from delayed diagnosis and treatment.

Paraffin waxes and white mineral oils are distinct petroleum products separated from a common feedstock by crystallization, where only n-alkanes, iso- and cyclo-alkanes with a linear backbone of ∼ 20 carbon atoms long, selectively crystalize out from the oil to form the wax, which is solid at room temperature, whereas oils remain liquid. Up until the 90's, these differences were reflected in separated regulatory assessments. A paradigm shift occurred when Fischer 344 rats (F-344) developed liver epithelioid granuloma following exposure to low and medium viscosity oils or waxes. This lesion was used as common denominator between these products to be jointly assessed under the common term "mineral hydrocarbons – MHC", obviating compositional differences. This regulatory paradigm dominated for the next 30 years, exacerbated by the EFSA 2012 evaluation using the analytical term "MOSH" (mineral oil saturated hydrocarbons) which encompassed these products under single chromatography fraction. The reconstruction of historical developments, together with recent EFSA-sponsored studies of toxicity and accumulation and supporting literature, has allowed us to understand the etiology of the F-344 rat hepatic epithelioid granuloma, which is presented in an adverse outcome pathway (AOP). Considering chemical composition, it clearly demonstrates that the hepatic effects in F-344 rats caused by linear alkanes of waxes are irrelevant for humans. Waxes are thus not MOSH and should thus be evaluated on their own merit. The term MOSH should not include n-alkanes and be exclusively used to mineral oil fractions when considering their chemical makeup for a relevant human hazard assessment. [ABSTRACT FROM AUTHOR]

Penile paraffinoma is a rare condition after penile injection of liquid paraffin or other mineral oils, with well-documented debilitating complications. Nevertheless, such injections are still performed by people of Eastern European and Asian descent for cosmetic penile augmentation. We report a case of penile paraffinoma in an otherwise healthy, 30-year-old male, with obstructive lower urinary tract symptoms (LUTS) as the sole complaint at presentation in the emergency department and a conservative approach. This case report describes an unusual presentation of penile paraffinoma in a young man and aims to raise public and physician awareness regarding disease manifestation to prevent high morbidity from delayed diagnosis and treatment. [ABSTRACT FROM AUTHOR]

A lipogranuloma is a complication of injecting exogenous oily composites, forming a nodule composed of foreign body histiocytes. These may be seen in the setting of use of anabolic steroids. We present a case of a 52-year-old male with rapidly growing intramuscular masses with accompanying lymphadenopathy and constitutional symptoms. A diagnosis of lymphoma was initially made in view of the multifocal nature of his disease. CT and PET/CT scans were used to profile the extent of disease. However, US-guided biopsy samples demonstrated acute-on-chronic fibro-inflammatory connective tissue, but no evidence of malignancy. A follow-up CT scan showed resolution of most of these masses. Subsequently, a history of self-injected anabolic steroids was obtained. Familiarity of imaging characteristics of lipogranuloma may be helpful in avoiding the pitfall of misdiagnosis in this clinical setting. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this case report we present two patients who developed symptomatic penile paraffinoma after self-injection with kanamycin ointment. Penile paraffinoma (sclerosing lipogranuloma) is a rare cause of a mass that can occur after injection of oil-based substances, paraffin, antibiotic ointment or vaseline into the penile shaft for penile augmentation and can cause serious complications such as infections, necrosis and erectile dysfunction. The geographic distribution of this practice is concentrated in Asia and Eastern Europe. Although penile paraffinoma can be rare, incidence is increasing due to migration of people from Eastern Europe in particular. Definitive management includes complete surgical excision with reconstruction as required. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Penile implants and injection of foreign materials have been described in texts like Kama Sutra for more than 1500 years, and are still being practiced around the world. The extent of this practice is unknown, and the documentation available today only scratches the surface. This study investigates and documents the complications after penile self-injections at the Mae Tao Clinic. To our knowledge, this study represents the largest series of patients representing complications to penile self-injections. Study design: Retrospective study. Methods: We investigated data on 680 patients admitted with penile self-injections during a 5-year period. Data were studied for general patient data, symptoms, time of injection, and treatment. Results: Age at admittance ranged from 17 to 68 with a mean age of 32 years. Time between injection and presentation was registered with a mean of 36.7 months, over half presented with complications within 1 year. Most frequent complications were penile pain (84%), swelling (82.5%), induration (42.9%), purulent secretion (21.8%), and ulceration (12.8%). Of the 680 patients, 507 (74.6%) underwent surgical treatment (503 excision and 4 circumcision), while 173 (25.4%) were treated conservatively. Conclusion: Our data suggest that penile self-injections with mineral oil are more prevalent in certain areas than previously acknowledged. In 5 years, more than 680 patients presented with complications to penile self-injections, of which 75% needed surgical intervention, mainly in the form of radical excision of the lesions followed by skin grafting. Preventive measures to this physically and psychologically devastating problem are highly warranted. [ABSTRACT FROM AUTHOR]

Toxicology feeding studies of mineral oil hydrocarbons (MOHs), within the carbon number range C22–C28, results in species-specific epithelioid granulomas in the liver of F-344 rats but not in other rat strains, or species. While MOH has been detected, and some pathological effects have been shown to occur in other organs/tissues of F-344 rats and other rat strains/species, it is generally accepted that the effect of toxicological concern is species-specific inflammatory liver granuloma. As oil retention and other MOH-related nontoxic pathological changes in the liver are observed in humans, some have hypothesized that the potential for oil accumulation over a lifetime, through dietary sources, may predispose humans to similar liver effects as observed in F-344 rats. To address this concern, a mode of action/human relevance framework (MoA/HRF) analysis for MOH-induced epithelioid granuloma in the F-344 rat model was developed. The key events for the development of liver epithelioid granulomas were identified as increased MOH intestinal absorption, preferential tissue retention and ultimately formation of necrotic granulomas encased by infiltrating inflammatory lymphocytes. The hypothesized MoA was evaluated using the modified Bradford Hill considerations for causality and was considered to be established in the F-344 rodent model. However, key strain/species differences in the rate of intestinal absorption, tissue retention of MOH and inflammatory response to MOH in the liver were identified. Overall, the F-344 rat MoA was not considered to be relevant to humans, consistent with data showing no evidence for the formation of epithelioid granulomas with humans even in cases of massive ingestion of MOHs. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Dermatology / Turk Dermatoloji Dergisis is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Nowadays lip augmentation with FDA‐approved fillers is becoming popular. However, because of financial concerns many patients seek for unregistered materials. Here, we report two cases who use vitamin E for lip augmentation. They experience severe infiltration and discharge less than one month after injection. Biopsy revealed lipogranuloma formation. They were treated with incision and drainage, antibiotic, and corticosteroids. Although these complications are usually difficult to treat, the patients had good clinical response and no recurrence in 5‐month follow‐up. [ABSTRACT FROM AUTHOR]

Summary Aim The aim of this study was to evaluate the clinical features of patients with a periorbital palpable mass or swelling after autologous fat injection for facial augmentation. Methods This retrospective case study included 50 patients who developed a periorbital palpable mass or swelling after undergoing autologous fat injection for facial augmentation performed by various plastic surgeons. The patients' medical records were reviewed for clinical history, radiological findings, and treatment outcomes. Results All patients were female with a mean age of 43.18 ± 12.04 (range, 19–63) years. After fat injection, the average time of symptom onset was 9.09 ± 8.45 (1–36) months, and the mean follow-up duration was 13 ± 1 (4–36) weeks. Majority of patients complained of eyelid swelling or periorbital palpable mass. All patients had received fat injection in the forehead area, except for the following patients: Five patients who were unaware of the site of fat injection and one patient who had received the injection in the upper eyelid area with simultaneous double-fold surgery. In addition, 39 patients had received a second injection of cryopreserved autologous fat tissue. Forty-five patients developed a mass in the upper eyelid area, four were found to have the mass in the lower eyelid area, and one patient developed the mass in both eyelids. Computed tomography and magnetic resonance imaging revealed isolated fat tissue, periorbital inflammation, or a soft tissue mass with fat density. Oral steroids were used to treat 41 (82.0%) patients; 31 (75.6%) showed satisfactory outcomes, nine (22.0%) patients did not return to the clinic after the first oral steroid treatment, and the periorbital mass persisted in one patient (2%) even after the oral steroid treatment. The patient with the periorbital mass underwent surgical removal and tissue biopsy. Asymptomatic patients (eight; 16%) underwent observation without treatment. As a first treatment, one patient (2%) requested an immediate surgical removal of the periorbital mass. Therefore, surgical excision and biopsy were performed in two patients (4%). During surgery, a granulomatous mass was found in the preseptal region, with liquefied necrotic fat flowing out. Histological examination revealed a lipogranuloma with granulomatous inflammation. Conclusions Clinicians should confirm a history of autologous fat injection and be aware of the clinical features in patients who present with a periorbital palpable mass or swelling. Oral steroid therapy should be considered before surgery because it may prove to be effective. Further studies with long-term follow-up periods are necessary. [ABSTRACT FROM AUTHOR]

The strive for proficient cosmetic facial appearance is growing in the past decades. Fillers for tissue augmentation are gaining wide popularity. Uncertified products based on oleic solutions are applied by untrained staff, thus growing the risk for certain complications such as infections, allergic and irritant contact dermatitis, and lipogranuloma formation. We present a series of three cases lipogranuloma after liquid vitamin E injection for lip augmentation. In all cases, painful edema at the injected area followed the procedure. The patients were presented with erythema, firm indurations of the lips and the perioral skin, and tenderness. Histological examination of skin biopsies showed round-ovoid cavities of varying sizes, resulting in a Swiss cheese-like appearance, consistent with a lipogranuloma. In this paper, we propose a protocol for treatment of this specific complication with systemic corticosteroids and a broad spectrum antibiotics. [ABSTRACT FROM AUTHOR]

Background Penile paraffinoma is a well-known delayed complication of paraffin oil injection into the penis for penile girth augmentation but its MRI features have not been previously described. Case presentation A 35-year-old Ukraine man presented with erectile dysfunction, voiding difficulty and an irregular, hard and painful penile mass that had progressively grown over the last year. He reported having received, seven years before, several penile injections of paraffin oil for penile girth augmentation. On physical examination, the mass was tender, poorly delimited, and involved the whole penile shaft and the cranial part of the scrotum. Preoperative MRI, performed to determine the extent of tissue to be removed and the possibilities of penile reconstruction, showed a newly-formed homogeneous tissue, compressing but not infiltrating Buck's fascia, iso-hypointense relative to muscle on T1-weighted sequences, and with a low signal intensity at T2-weighted sequences. On T1-weighted fat suppressed sequences, it did not enhance with contrast administration. MRI data were confirmed by surgical findings, as the newly-formed scar tissue did not infiltrate Buck's fascia. Pathology confirmed the diagnosis of penile paraffinoma. Conclusion MRI seems to provide an adequate imaging of the histological events occurring after injection of paraffin oil in the subcutaneous tissues. Penile paraffinoma remains a clinical diagnosis, but MRI features may be helpful in planning an adequate surgical strategy and, in selected cases, establishing the differential diagnosis with other penile diseases, including cancer. [ABSTRACT FROM AUTHOR]

Fillers for lip augmentation have become more and more popular in recent years and seem to be indispensable in the cosmetic market nowadays. A series of six young females is presented who developed massive swellings and pain after vitamins A and/or E lip augmentation. The vitamins were extracted from gelatinous capsules (Gericaps [Adipharm EAD, Sofia, Bulgaria], Geritamins [Actavis EAD, Balkanpharma-Dubnitsa AD, Bulgaria], or vitamin E yellow gel capsules) and injected by unprofessional physicians and beauticians in different cosmetic centers. Physical examination revealed firm indurations of the lips and perioral skin, tenderness, erythema, and hard dermal nodules. Histological analysis revealed numerous round-to-ovoid cavities of varying sizes, resulting in a Swiss cheese-like appearance, consistent with lipogranulomas. The patients were treated with systemic and intralesional triamcinolone injections and broad-spectrum antibiotics with good clinical response. In conclusion, these cases demonstrate the danger of the use of unregistered products as fillers injected by unprofessional physicians and beauticians. [ABSTRACT FROM AUTHOR]

Lipogranuloma is an uncommon inflammatory reactive process related to endogenous or exogenous lipid materials. Although lipogranuloma most frequently involves the penis and scrotum of young adults, it may affect many other organs. This report describes primary axillary lipogranuloma in a 45-year-old woman with systemic lupus erythematosus in the light of the mammographic and ultrasonographic findings of this rare entity. This is the first report of primary axillary lipogranuloma in the literature in English. [ABSTRACT FROM AUTHOR]

Introduction Body contouring injections by non-licensed providers are frequently sought out by a subset of the male-to-female transgender community. Although short-term side effects such as pulmonary embolism and injection site infection are well known, long-term consequences of such practices are less well studied. Case presentation Here we describe the case of a 40-year-old African American male-to-female transgender patient who presented to our institution with hypercalcemia and acute renal failure secondary to body contouring injections with industrial strength silicone by non-licensed providers, a decade prior to her visit. Work-up revealed an extensive granulomatous inflammatory process in the injection area resulting in electrolyte abnormalities and kidney injury. The patient's lab results and symptoms responded well to long-term corticosteroid treatment and correlated with treatment adherence. Conclusion Affected patients can sometimes present with unusual clinical symptoms many years after silicone injections. In a constantly growing transgender community that often utilizes nonlicensed providers for silicone injections, the medical community will likely face an increasing number of patients with long-term side effects of such practices. Therefore, it is imperative for physicians to recognize such cases promptly and initiate potentially life-saving treatment. [ABSTRACT FROM AUTHOR]

Background Penile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier's gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin selfinjection for penile girth augmentation presenting with acute urinary retention. Case presentation A 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up. Conclusions The present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters. [ABSTRACT FROM AUTHOR]

Background: We report two cases of unilateral upper eyelid swelling with multiple small lumps as an unusual complication of autogenous fat injection for cosmetic forehead augmentation. Case presentation: Two female patients were referred to our clinic for unusual unilateral eyelid swelling, with multiple small lumps. The duration of symptoms differed in each case, but both patients had a history of autogenous fat injection for cosmetic forehead augmentation at a local plastic surgery clinic. The lumps were small (diameter 5 mm~10 mm), palpable, hard, and nonmobile, and were evaluated by magnetic resonance imaging (MRI). Lumps from the eyelids of two patients were excised under general anesthesia. All of the masses were located deeply and found near the superior orbital rim or lateral orbital rim. The lumps exhibited chronic inflammation with fibrosis. Some of the lumps showed foamy histiocytic aggregation and foreign body lipogranuloma, resulting from iatrogenic fat injection. After excision, all masses and swelling disappeared, and moderate ptotic eyelid or lagophthalmos of affected eyes also improved. Conclusions: To our knowledge, eyelid swelling with multiple lumps in the eyelid is a very rare complication of autogenous fat injection for cosmetic forehead augmentation. This report should be helpful for ophthalmic clinicians who encounter these unusual symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Penile paraffinoma, also called penile mineral oil granuloma, occur after injection into the penis of foreign bodies such as mineral or vegetable oils. Clinical case: We present the case of a 29 years old male Gypsy patient who was consulted for nodules and fistulas on his penis. History revealed self-injection of kanamycin ointment into the penis body one year ago for the purpose of increasing the penile size. The diagnosis of penile paraffinoma was made. Circumcision with removal of nodules was performed. Histopathological examination by hematoxylin and eosin staining revealed the replacement of subcutaneous tissue with vacuolar lesions and a lymphocytic infiltrate with foreign-body giant cells. Discussion: Mineral or vegetable oils injection into the penis or other skin areas can be followed after a period of several years by the appearance of foreign body reactions with lipogranulomas formation. Other complications such as infection, skin necrosis, ulceration, fistulization, invasion of corpus cavernosum, embolism and even death may occur. Conclusion: The practice of injecting mineral and vegetable oils into the penile body, although abandoned in European countries, can be found in certain parts of the world and in certain social environments. [ABSTRACT FROM AUTHOR]

Sinonasal myospherulosis is a foreign body reaction to lipid material used on nasal packing at the conclusion of paranasal sinus surgery. Rare cases have been sporadically reported. We report a case found in a 79-year-old female 8 months after functional endoscopic sinus surgery during which sinus cavities had been packed with gauze coated with Terra-Cortril (a paraffin-based tetracycline/steroid ointment). The preoperative diagnosis was suggested during CT of the paranasal sinuses by the presence of macroscopic paraffin retention cysts having a characteristic fat density. To our knowledge, our case represents the first report of sinonasal myospherulosis suggested by CT. [ABSTRACT FROM AUTHOR]

Olive oil is commonly employed as a solubilizing agent for lipophilic materials in preclinical studies in rodents. Here we report that following subcutaneous (SC) injection of olive oil to Sprague-Dawley (SD) rats, local SC lipogranulomas formed, which were associated with an unusual location of the same changes in the peritoneum. Macroscopically, multifocal white spots were found over the liver and mesentery. Histologically, lipid granulomas were seen in the SC injection site, as well as on the capsular or serosal surface of the abdominal organs. No abnormal clinical signs were noted except for swelling at the injection site. The olive oil may have reached the peritoneal cavity from the SC tissue passively via the lymphatic vessels or actively after engulfment by antigen-presenting cells via the lymphatic or blood vessels. These findings are of particular importance for drug safety assessments, as the occurrence of lipogranulomas in locations distant from the site of administration may lead to misinterpretation of histological results. We suggest that these aberrations may be induced by the administration of olive oil as a vehicle. [ABSTRACT FROM PUBLISHER]

Sclerosing lipogranuloma of the male genitalia is a rare condition presenting with subcutaneous masses on the penis and scrotum. The cause and pathogenesis of this lesion have been the subject of considerable interest as it still lacks a well defined etiology. The main hypothesis about the pathogenesis is exogenous lipid degeneration related to subcutaneous injection of foreign bodies such as paraffin or topical use of oily drug preparations for penile augmentation. However, in some cases this granulomatous inflammatory lesion may be due directly to allergic mechanisms induced by heat, cold, or trauma. We present the case of a 32-year-old man with penile sclerosing lipogranuloma and discuss the cause and mechanisms of this process. [ABSTRACT FROM AUTHOR]

A-25-year-old man was admitted because of a painless tumor of the scrotum. The patient denied a history of exogenous material injection and trauma in the scrotum. Physical and radiological examination revealed a mass in the scrotum, and blood laboratory tests showed no significant findings except for mild eosinophilia (5.6%). Resection of the mass was performed. The mass was isolated and located in the subcutaneous tissue of the scrotum. The mass was rectangular and symmetrical, and measured 65 × 45 × 15 mm. Histologically, the mass was composed of adipose tissue with fibrosis. Many epithelioid granulomas with multinucleated giant cells of foreign body and Langhans’ types and heavy infiltrates of lymphocytes and eosinophils were recognized. Characteristically, the lesion showed broad coagulative and lytic necrosis. Congestion and edema suggestive of ischemia were seen in some areas. Special stains for acid-fast bacteria, gram-positive bacteria and fungi failed to detect any microorganisms. Polymerase chain reaction for mycobacterium tuberculosis revealed no reaction products. Immunohistochemically, the majority of lymphocytes were CD45RO-positive T cells, and S-100 protein-positive cells and CD68-positive macrophages were scattered in small amounts. The appearances were typical for sclerosing lipogranuloma except for the necrosis. Although the pathological mechanism of the broad necrosis is unclear, the necrosis might be the result of ischemia. Our case suggests that primary sclerosing lipogranuloma of the scrotum might show broad necrosis, and that T-cell-mediated immune response might play a part in the formation of lipogranuloma. [ABSTRACT FROM AUTHOR]

We report on a rare manifestation of Erdheim-Chester disease with intramuscular lipogranuloma. The patient was a 66-year-old man who noted a soft tissue mass in the right quadriceps femoris muscle. Radiographs revealed symmetrical osteosclerosis in the diametaphysis of both femora and tibiae. An open biopsy revealed a proliferation of lipid-laden histiocytes in the femoral bone marrow and the quadriceps femoris muscle. To our knowledge, this is the second case of Erdheim-Chester disease involving muscle. [ABSTRACT FROM AUTHOR]

Penile paraffinoma or sclerosing lipogranuloma is a disease occurring uncommonly in Czechia; a pathologist meets this only rarely. Microscopically, we deal with chronic fibroproductive inflammation localised usually in subcutaneous tissue of the penis. It is caused by previous voluntary injection of liquid paraffin / mineral oil for the purpose of penis circumference augmentation, usually performed by a non-healthcare person or by the patient himself. Human tissues do not have enzymes that can break down synthetic lipids. The application leads, with a variable time lag, to a foreign body giant-cell reaction lasting for years, and often to annoying complications frequently associated with a genital mutilation and sexual dysfunction. The lesion often requires surgical treatment to remove the paraffin substance from the subcutaneous tissue. The surgery does not always lead to satisfying results and the paraffinoma tends to recur. In this article, we describe a case of a man with relapsing paraffinoma, which required excision of subcutis with subsequent plastic surgery with skin graft. During histological examination, lipid droplets were found in dermis and in subcutis, along with xantogranulomatous inflammation. The lipid nature of the material was proven by oil red and Sudan stain. The paper includes clinical and histopathological differential diagnostic consideration, summary of treatment options and relevant literature review.

ABSTRACT- Portal lipogranulomas in liver biopsy specimens were investigated. The incidence of biopsies containing portal lipogranulomas was 2.4%. Out of 20 biopsies with lipogranulomas 10 biopsies contained only one lipogranuloma. Portal lipogranulomas show a distinctive morphology with fat vacuoles surrounded by macrophages. They are consistently found together with parenchymal steatosis and probably originate from parenchymal fat being transported to portal tracts. Portal lipogranulomas are of importance in the differential diagnosis from other granulomas. [ABSTRACT FROM AUTHOR]