Lipoma is a benign tumor formed by proliferation of mature adipose tissue. It is mostly seen in adults aged 40 to 50 years old. The tumor is soft, round or lobulated, located under the skin, and can be pushed; the size of the tumor varies, small ones are as big as dates and can be palpated by hand, while large ones can be elevated on the skin surface, but the surface skin is normal. The tumor is single or multiple and can be found in any part of the body, with shoulder, back and abdomen being the most common. Most of them have no conscious symptoms. Angiomyolipoma is a special type of lipoma, which is more common in young people and is usually found in the lower limbs. They are most commonly found in the neck, shoulders, back, buttocks, subcutaneous tissues of breasts and limbs, face, scalp, scrotum and labia, followed by the retroperitoneum and gastrointestinal wall; very few of them may appear in areas where there is no adipose tissue. If the proportion of fibrous tissue in the tumor is high, it is called fibrolipoma. The size of lipoma varies, most of them are flat and round or lobed with clear demarcation; those with unclear boundary should be aware of the possibility of malignant lipoma. The tumor is soft and elastic (distinguish it from larger cysts), and some of them may have pseudo-volatility. The tumor does not adhere to the epidermis, the skin surface is completely normal, and the base is more extensive. When the tumor is examined, the lobe pattern can be seen by pressing the base of the lipoma. The skin may appear as “orange peel”. The tumor develops very slowly, and most of them have no serious adverse effects on the body, and malignant changes are rare. In addition, there is another type of multiple round or oval nodular lipomas, which are commonly found in the extremities, waist and abdomen under the skin. The size and number of these tumors are variable, and they are slightly harder than normal lipomas and painful when pressed. Lipomas are usually painless and do not cause any discomfort. Lipomas are slow growing and multiple lipomas are usually small and soft in texture and may have a pseudocystic feeling. Lipomas often occur in multiple sites and have a family history. They can be left untreated if there are no obvious symptoms. Surgical removal is required only when the following conditions occur and there is a possibility of malignant change: local pain and discomfort; large tumor affecting the aesthetics or tumor affecting the function of the limbs; accelerated growth and enlargement of the tumor and suspicion of malignant change; solitary lipoma growing in deeper areas. Liposarcoma is not liposarcoma, but liposarcoma is a kind of tumor with higher malignancy, which grows rapidly, has larger tumor and harder texture, and is mostly solitary. Complications of surgery 1.Anesthesia accident, resulting in respiratory and cardiac arrest, which is life-threatening. 2.Damage to the surrounding large blood vessels during surgery, resulting in hemorrhage and life-threatening. 3.The “syndrome” after lipoma removal: a series of clinical symptoms caused by the complication rate of about 20-30%, specific symptoms include: persistent diarrhea, abdominal distension, nausea, vomiting, anorexia and other indigestion symptoms and general weakness, pale, tiredness and other malnutrition symptoms, there is no effective treatment for such complications. 4.Surgery can damage the surrounding adjacent organs, thus causing functional impairment of the corresponding organs, which can cause fatal consequences in serious cases. Type Lipoma (lipoma) is usually considered a common benign soft tissue tumor consisting of mature fat cells. Because the vast majority of lipomas do not cause immediate symptoms or complications and have no difficulty in diagnosis, research into the nature of lipomas has failed to attract attention and progress has been slow. Lipomas include the following four types: ① The most common type of lipoma is usually the common subcutaneous lipoma. It consists of mature fat and a small amount of mesenchymal tissue, and can be solitary or multiple, presenting as a subcutaneous or deep soft mass. ② Other types of specific lipomas. Such as angiomyolipoma and muscle lipoma, which are clinically or pathologically different from ordinary subcutaneous lipomas. (iii) Ectopic lipomas. These may be misshapen tissues and differ from subcutaneous lipomas in the site of occurrence, such as intermuscular lipoma, angiomyolipoma, and neurofibrillary lipoma. From the pathogenesis and modern biomolecular theory, we finally concluded that the root cause of various types of lipoma is the “lipoma tumorigenic factor”. However, under the influence of various internal and external environmental factors, the activity of this tumorigenic factor is active and has certain activity. When the resistance of the body decreases, immune cells such as mononuclear phagocytes have a reduced ability to monitor the tumorigenic factor, coupled with changes in the internal environment, stimulation of chronic inflammation, and abnormal systemic fat metabolism, the activity of lipoma tumorigenic factor is further enhanced and combined with certain gene fragments in normal cells of the body to form abnormal mutations, causing an abnormal proliferation of normal fat cells and surrounding tissue cells, resulting in The lumps that are related to the deposition of adipose tissue and protrude to the body surface or various internal organs are called lipomas. People who consume excessive alcohol and often eat fatty meat, animal offal, fish without scales or egg yolk. Because eating too much fatty and greasy products and high cholesterol food can cause dampness and heat in the spleen and stomach, phlegm and dampness inside, and dysregulation of transportation and transformation, i.e., too much newborn adipose tissue, so that too many fat cells in the body are heterogeneous and hardened. The treatment principle is: to remove heat and dampness, to strengthen the spleen and stomach, and to soften and disperse the knots. Second, people with excessive work pressure, irritable mood and frequent anger. Because of liver qi stagnation, qi and blood do not flow smoothly, the meridians do not work, which can cause normal adipose tissue and stagnant blood to intertwine together, which can form connective tissue wrapped around fat cells for a long time and form lipoma. Treatment principle: dredge liver and qi, invigorate blood circulation and remove blood stasis, soften hardness and disperse knots. Through treatment to open up the meridians, dredge the blood and dissipate the lipoma. Third, people who often stay up late and think too much about problems. Because of the injury to the spleen and stomach, the spleen is not healthy and the yin and yang are out of balance, so that the body’s ability to decompose fat decreases, and the original fat tissue and new fat cannot be arranged normally, forming abnormal fat tissue, i.e. “lipoma”. Pathology During histopathological examination, in addition to large mature adipocytes, most hyperplastic blood vessels can be seen in the tumor body. Lipomas are rarely cancerous and generally do not require treatment; if the tumor is large enough to interfere with activity, or if it suddenly increases in size or breaks down in the near future, it should be surgically removed. The tumor mostly occurs under the skin and is surrounded by a thin connective tissue capsule containing normal adipocytes that are divided into lobular clusters by connective tissue bundles. Some lipomas contain a large amount of connective tissue or blood vessels in addition to a large amount of fatty tissue, resulting in a complex lipoma. The number of lipomas can be divided into two categories: isolated lipomas and multiple lipomas. These tumors are usually found in the shoulders, back, buttocks, extremities, waist, subcutaneous abdomen and inner thighs, and are also common in the head. Lipomas located in subcutaneous tissues vary in size and are mostly flat and round or lobulated with clear demarcation; those with unclear demarcation should be beware of the possibility of malignant lipoma. A single lipoma is called an isolated row of lipomas. Two or more are called multiple lipomas. According to the location, it can be divided into subcutaneous lipoma and vascular smooth muscle lipoma (also known as wrong hook tumor). Depending on the location of the lipoma, subcutaneous lipomas are flat or lobulated, soft, subcutaneous masses with clear borders. They are soft, pushable, have normal skin, develop slowly, and number in the hundreds, often under the skin. Vascular smooth muscle lipoma is a lipoma that occurs between the smooth muscle tissues of capillaries in various organs (kidney and liver are more common) (also known as renal and hepatic malignant lipoma). Lipomas are classified into three types of phase II, or PNM classification, depending on their growth status. They classify lipomas into three types and two stages according to the presence or absence of clinical symptoms, duration of disease, associated diseases, growth rate, shape, location, size, and complications of lipomas. The main significance of this classification method is that different clinical typing and staging have their specificity in the treatment process. Only by accurately grasping the different typing and staging of lipoma can we treat this disease more accurately and effectively and make the treatment more detailed. Clinical diagnosis It is understood that most of the body surface swellings will not grow indefinitely, but some of them may change, how to judge their fortune and misfortune. The growth rate of the mass: tumor cells have a tendency to grow, benign tumor cells grow slowly, once the growth rate of the mass is accelerated, in a short period of time, such as one or two months, two or three months than before, most of them grow exponentially or several times, it may be a manifestation of malignant change. There is no absolute value for this growth rate, but mainly a comparison with the previous one. Touch the shape of the mass: most of the masses with regular shape and clear edges are benign; on the contrary, those with irregular shape, unclear edges and uneven surface are mostly malignant. For example, if a lump on breast is lipoma or cancer, lipoma is smooth and complete to touch, can be pushed, and does not adhere to the skin, while cancer is not smooth on the surface and resembles burr-like, and the lump adheres to the skin. Look at the hardness of the mass: the harder the mass is, the higher the possibility of malignancy. Look at the mobility of the mass: benign masses are more mobile, i.e. separated from surrounding tissues, such as lipomas, which are soft and can be pushed by hand; while malignant masses are less mobile or even inactive, adhering to the skin and the base. Look at the surface of the swelling to see if there is ulceration: if the swelling on the body surface breaks down, in addition to tuberculosis or with local infection, malignant tumor should be suspected. Compare with the above methods, if you have doubts, you should be alerted. Lipoma is a fat metabolic disease, so all parts of the body rich in fat are good sites for lipoma. Among them, shoulder, back, upper arm, hip and knee joints are the most common. The tumors often vary in size, from small ones that look like soybeans to large ones that can weigh more than 20 kg. The lump develops slowly, is flat and round, soft and elastic, with clear borders and a sense of lobulation when touched. If the hand presses the base of the tumor, the skin surface can be wrinkled and depressed due to the pulling of the fiber bundle, which is “orange peel-like”. Another kind of lipoma is multiple, which is symmetrically distributed all over the body, but mostly seen on the back and limbs, small like a soybean, occasionally as big as a fingertip, with clear edges that can be pushed, and mild adhesion to the skin, which is painful when pressed. Lipomas can be easily confused with other diseases. Lipomas are very common and usually do not require treatment. However, if other malignant tumors are misdiagnosed as lipomas, the disease can be delayed and become a big mistake. Therefore, it is necessary to distinguish this disease from other similar tumors: Lipoma (sebaceous cyst) is a small tumor, mostly shaped like a bean, round and soft, with an external capsule, and when broken, it exudes a filthy beanbag-like substance and has a foul odor. In addition, there is no long-term clumping at the lesion site before the onset of the disease. Multiple neurofibromas with hollow swellings are more obvious with acupressure and are accompanied by special freckle-like nevi and mental retardation and other related symptoms. 1. Diagnosis of the disease is mainly based on symptoms and physical examination. Especially the physical features of the mass. 2. In order to differentiate from other diseases, the examination protocol may include examination box “B”. a. It usually occurs in the neck, back, scapula and forearm, but can also occur in other parts of the body. b. Mostly seen in adults. c. Most are multiple and a few are solitary. d. The masses vary in size, are oblate or round, with clear borders, unchanging skin color, soft texture, a few are hard and painless to touch, but have a pseudo-volatile sensation; typically, when the mass is squeezed tightly with the hand, the surface can appear lobulated, and the masses grow relatively slowly. Diagnostic basis (1) It is usually found in the neck, back, scapula and forearm, but can also occur in other parts of the body. (2) Most commonly seen in adults. (3) Most of the cases are solitary, but a few are multiple. (4) The masses vary in size, are oblate or round, with unclear borders, unchanging skin color, soft texture, and are not painful to touch, but have a pseudo-fluctuating sensation. Typically, when the mass is squeezed tightly with the hand, the surface may appear lobulated, and the masses grow relatively slowly. Powder tumors, lipomas, and neurofibromas are common benign tumors on the body surface. Powder tumor, also known as sebaceous cyst. They are located in the dermis, have an intact envelope, and store tofu-like secretions with a foul odor. Soybean size, date size or larger. The face, behind the ears, back and buttocks are the preferred sites. It is prone to infection and pus in summer. Lipomas are located in the subcutaneous adipose tissue and are formed by the accumulation of mature fat cells. They mostly develop on the trunk and upper limbs. They are numerous and vary in size, with some being as large as a fist. They are oblate or round, lobulated, and have an intact thin envelope. The texture is soft and the cut surface is pale yellow. Neurofibroma is a dominantly inherited disease with a family history. They originate from nerve trunks or nerve endings in various parts of the body, are located subcutaneously, and are characterized by multiple occurrences. The tumor is small, pushable, tough, well-defined, and without envelope. The cut surface is grayish white and translucent.