title: Insulin-induced lipohypertrophy: report of a case with histopathology.
abstract: An 82-year-old woman with type 2 diabetes had been treated with recombinant human insulin for 16 years. She developed large swellings in both sides of her lower abdomen. The masses were soft, painless, and located around her insulin injection sites. Based on the history and clinical features, a diagnosis of insulin-induced lipohypertrophy was made. Total resection revealed that the lesions were composed entirely of fatty tissue. Microscopic examination showed nests of mature adipocytes expanding toward the dermal reticular layer. The hypertrophic adipocytes were twice as large as those from normal subcutaneous areas and contained numerous small lipid droplets. Electron microscopic analysis also revealed a minor population of small adipocytes, suggesting active differentiation or proliferation. Thus, the possible in vivo effects of insulin on adipocytes were clearly observed in this case of insulin-induced lipohypertrophy. To our knowledge, this is the first report of insulin-induced lipohypertrophy with detailed histological examinations.
authors.affiliation: Department of Medicine and Clinical Science, Division of Endocrinology and Metabolism, Kyoto University Graduate School of Medicine, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Fujikura
authors.forename: Muneya
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yasue
authors.forename: Michio
authors.initials: M
authors.lastname: Noguchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Masuzaki
authors.forename: Kiminori
authors.initials: K
authors.lastname: Hosoda
authors.forename: Takao
authors.initials: T
authors.lastname: Tachibana
authors.forename: Hajime
authors.initials: H
authors.lastname: Sugihara
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
mesh_terms: D017667:Adipocytes / Q000473:pathology / Q000648:ultrastructure; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000009:adverse effects*; D008060:Lipodystrophy / Q000139:chemically induced* / Q000473:pathology; D008855:Microscopy, Electron, Scanning
chemical_list: D007328:Insulin