University study: Fat tissue after lipolysis of lipomas:
A histopathological and
immunohistochemical study
New York, NY (JULY, 2006) -- The Journal of Cutemous Pathology has published a study on Lipodsissolve (known as injection lipolysis in Europe) use on lipomas in the 2006 issue of the journal. The published report was based on a collaborative effort between Ruhr-University Bochum, Bochum, Germany and UCLA, California.
Background: Injections with phosphatidylcholine (PDC) containing substance, have become a popular technique to treat localized fat accumulation and lipomas for aesthetic reasons. Despite its frequent use, the mechanism of action of PDC and histological changes of treated fat tissue still remain unclear. [The purpose of the study] To investigate the histological changes of lipomas after treatment with PDC.
Methods: In all, fourteen lipomas (n ¼ 14) in five patients presenting with multiple lipomas were treated with intralesional injections of PDC (Nettermann, Germany). Histological changes with immunohistochemical analysis of the inflammatory process were evaluated 4, 10, 24, 48 h, 10 days, 30 days and 60 days after lipolysis.
Results: Between 4 and 48 h after injection, histology shows a lobular neutrophilic infiltrate with partially destroyed fat cells. At day 10 the inflammatory process is accompanied by an infiltration of T-lymphocytes. After 60 days formation of macrophages with foam cells are visible, accompanied by thickened septa and capsula.
Conclusion: Lipolysis with PDC results in a distinct inflammatory reaction of affected fat tissue, similar to factitial panniculitis. Early destruction of fat cells may suggest the involvement of detergent or osmotic mechanisms in the process.
Our study group also evaluated the clinical outcome of lipoma lipolysis by means of ultrasound control. We could show minor complications such as hematoma in 27%, and pain limited to pressure on the treated sites in 40%. No severe complications occurred.
[Image] Fat tissue after lipolysis (with Lipodissolve) of lipomas: Fig. 2. (A) 4 h after injection of phosphatidylcholine.
Visible lobular neutrophilic panniculitis accompanied by dilated and congestive capillaries within the fat lobule
(hemalaun–eosin 320).
(B) 10 h after injection. Lobular neutrophilic panniculitis accompanied by adipocytes varying in form and size (HE 310).
(C) 24 h after injection. Immunohistology (myeloperoxidase) revealing the dense infiltrate of neutrophils (320).
(D) Higher magnification (340) 24 h after injection. Adipocytes differ in size and reveal an atypical form.
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