Differentiation of Lipedema Nodules and Angiolipomas Based on the Ultrasound and Histopathologic Findings: A Case Series

Nódulos hiperecoicos no subcutâneo de pacientes com lipedema podem se parecer com angiolipomas no ultrassom, mas representam um processo inflamatório e hipóxico-isquêmico, e não uma neoplasia — ainda que haja expansão do tecido. Como esses nódulos são dolorosos e crescem, a biópsia costuma ser indicada para afastar câncer.

Esta série de casos compara os achados de ultrassom e de histopatologia de dois pacientes com nódulos de lipedema e dois com angiolipoma, propondo critérios ultrassonográficos para distinguir as duas entidades. O objetivo é prático: muitos profissionais ainda conhecem pouco o tema, e o diagnóstico diferencial correto evita conduta desnecessária.

Referência completa

Vargas D, Foureaux TO, Wortsman X, Sigrist RMS, Lellis R, Chagas LC, et al. Differentiation of lipedema nodules and angiolipomas based on the ultrasound and histopathologic findings: a case series. Cureus. 2026;18(8):e114807. doi:10.7759/cureus.114807

Abstract

Hyperechoic subcutaneous nodules in lipedema may mimic angiolipomas but represent an inflammatory and hypoxic-ischemic process rather than a neoplasia, despite tissue expansion. As the painful nodules expand, biopsy is recommended to exclude cancer. In this context, ultrasound (US) has become a pivotal tool for diagnosing and managing these nodules when combined with histopathologic assessment. However, many professionals in the field still have limited knowledge of this topic. In the present case series, the US and histopathologic findings of hyperechoic nodules in two patients with lipedema were compared with those observed in two patients with angiolipoma, with the aim of proposing US criteria to distinguish between these entities and highlighting the importance of accurate differential diagnosis.

Original abstract as published in Cureus.