Abstract
BackgroundMadelung’s disease (MD) is a rare disorder of fat metabolism, which is usually associated with diabetes, hyperuricemia, liver disease, nevertheless there is no report of a patient with MD and pulmonary aspergillosis (PA). This article aimed to enhance the awareness of this two diseases and discuss the possible mechanism of the combination of them preliminarily.Case presentationIn this case, we described a 56-year-old male patient with cough, expectoration and dyspnea. His neck has a very peculiar appearance. Chest enhanced CT scan showed there were multiple nodules in both lungs, some of which had cavities and the mediastinal lymph nodes were swollen. Ultrasound scan of the neck showed diffuse hyperplasia of subcutaneous fat in neck and bilateral supraclavicular fossa. Fortunately, after performing pulmonary wedge resection aimed at pathological examination and giving relevant treatments, this patient was finally diagnosed as MD with PA, and his symptoms were significantly relieved.ConclusionsMD is rare, the phenomenon that MD combined with PA is rarer. Immune disorder may be the possible mechanism.
Highlights
Madelung’s disease (MD) is a rare disorder of fat metabolism, which is usually associated with diabetes, hyperuricemia, liver disease, there is no report of a patient with MD and pulmonary aspergillosis (PA)
Multiple symmetric lipomatosis (MSL), called Madelung’s disease (MD), is a rare disorder of fat metabolism, which is characterized by progressive, symmetric deposition of non-enveloped adipose tissue between superficial and deep fascia in typical locations [1]
Pulmonary aspergillosis (PA) is caused by a variety of Aspergilli which is a king of opportunistic pathogen
Summary
Multiple symmetric lipomatosis (MSL), called Madelung’s disease (MD), is a rare disorder of fat metabolism, which is characterized by progressive, symmetric deposition of non-enveloped adipose tissue between superficial and deep fascia in typical locations [1]. Case presentation A 56-year-old male patient was presented to our hospital due to cough, expectoration and dyspnea for more than half a year. Chest CT examination in the local hospital showed that there were multiple cavitary shadows in bilateral lungs. For further diagnosis and treatment, he came to our hospital This patient had a 30-year personal history of smoking and a 38-year history of heavy drinking. Symmetric swellings were observed on neck, back and upper chest, which were painless, soft and had clear boundary (Fig. 1). Breath sound of both lower lung fields was weakened slightly and there was a little wet rale. Chest enhanced CT scan showed there were multiple nodules in both
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