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

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.